Acinetobacter baumannii belongs to a species of gram unfavorable, oxidase negative organisms. It is non motile and on microscopic examination appears as coccobacilli in pairs. Till date, about 25 totally different sorts of this organism have been recognized. These micro organism are generally found within the water and soil and recent evidence has shown that also they are discovered to be colonizing the pores and skin, throat and other sites in healthy human people (Defense, 2005).
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These organisms are essential in causing outbreaks of infections particularly focused at groups of people who’re immunocompromised or critically unwell particularly those that have contracted traumatic injuries either in the context of pure disasters or during struggle circumstances (Scott, 2007).
These organisms could be acquired from the environment via contacts with fomites which have been contaminated through the environmental reservoir or more generally via the arms of infected health care personnel and research have proven that just about one third of well being care professionals carry this organism on their hands.
Therefore, nosocomial infection of A.
baumannii is a standard and properly established entity and is turning into a serious well being concern over the previous few a long time. Moreover, in temperate climates, this organism has also been proven to contaminate wounds and therefore trigger infections in wounded individuals (Defense, 2005). The most typical infections brought on by A. baumannii include nosocomial pneumonias, skin and wound infections, urinary tract infections, central nervous system infections (e. g. eningitis) and frank sepsis (Defense, 2005). Recently, there was a rising concern over the growing incidence of A. baumannii infections in army personnel, concerned within the Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), admitted in numerous well being care amenities in Iraq, Kuwait and Afghanistan (Scott, 2007).
By August 2004, there were 102 recognized cases of A. baumannii infections amongst navy individuals involved in OIF and OEF (Prevention, 2006).
Similar infections have been observed in the past and A. baumannii was identified as the most commonly recovered gram unfavorable organism from people who had acquired traumatic injury to the extremities through the Vietnam War (Prevention, 2006). Keeping the above talked about data in thoughts, the significance of Acinetobacter baumannii infections from the army perspective can be gauged. Moreover, an necessary facet of infections with A. baumannii is the emergence of multidrug resistant strains of this organism.
Studies have shown that this organism, in addition to buying resistance to antimicrobial remedy as a result of publicity to several antibiotics and single drug therapy, also possesses an intrinsic resistance to certain antimicrobial agents (Prevention, 2006). This makes treatment troublesome and poses two primary public well being concerns viz. the development of stringent strategies for the prevention of the spread of such infections and discovering newer antimicrobial agents to which the resistant strains of A. baumannii are vulnerable.
Till date, the antimicrobial agents which have been successful in combating A. baumannii infections embrace the Carbapenems (e. g. Impenem and Meropenem), Amikacin, and Colistin (Defense, 2005). Studies and antimicrobial susceptibility testing has proven that most A. baumannii isolates, together with those which have been present in samples of sufferers from OEF and OIF, are prone only to Colistin (Polymyxin E). However, use of this antimicrobial agent is limited because of its excessive potential for causing toxicity (Prevention, 2006).
Other agents that are underneath investigation via in vitro testing for effectiveness towards Acinetobacter baumannii include piperacillin/tazobactam, most third-generation cephalosporins, aminoglycosides, and fluoroquinolines (Defense, 2005). The source of acquisition of A. baumannii by army sufferers is an arena of controversy. Three potential sources have been viz. pre-injury skin colonization, introduction of the organism into the wound at the time of damage, and nosocomial acquisition of the organism after harm throughout remedy in well being care facilities.
Scott (2007) of their review of patients from the OIF and OEF discovered that though the outbreak of multidrug resistant A. baumannii is multifactorial, an important supply of an infection is nosocomial unfold of infection in sufferers admitted within the health care facilities (Scott, 2007). In conclusion, there is a rising concern of the current enhance in the incidence of Acinetobacter baumannii amongst military people. Moreover, several multidrug resistant strains have emerged over the previous few many years. This has critical public health implications and new methods to control the further spread of those infections need to be devised.