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Acinetobacter in the Critically Ill
- As all of us know, there has been an alarming increase in the incidence of acinetobacter infections
- At present, infections mostly occur in ICU/critically ill patients
- Important risk factors for colonization and infection include mechanical ventilation, recent surgery, tracheostomy, residents of long-term care facilities, central venous catheterization, and enteral feedings
- The most frequent clinical manifestations are ventilator associated pneumonia and bacteremia
- Susceptible strains can be treated with a broad-spectrum cephalosporin, carbapenem, or B-lactam-B-lactamase used alone or in combination with an aminoglycoside
- For resistant strains, the most active agent in vitro are the polymyxins
- The most common adverse effect of the polymyxins is nephrotoxicity (up to 36%)
- Tigecycline has been used but resistance rates are rapidly increasing
References
Munoz-Price LS, Weinstein RA. Acinetobacter infection. NEJM 2008;358:1271-81.