Acinetobacter baumannii: Emergence of a Successful Pathogen Anton Y. Peleg, Harald Seifert and David L. Paterson Clin. Microbiol. Rev. 2008, 21(3):538. DOI: 10.1128/CMR.00058-07. Downloaded from Updated information and services can be found at: http://cmr.asm.org/content/21/3/538 These include: http://cmr.asm.org/ REFERENCES This article cites 610 articles, 321 of which can be accessed free at: http://cmr.asm.org/content/21/3/538#ref-list-1 CONTENT ALERTS Receive: RSS Feeds, eTOCs, free email alerts (when new articles cite this article), more» on November 25, 2011 by CONSOL.CAPES-T299093 Information about commercial reprint orders: http://cmr.asm.org/site/misc/reprints.xhtml To subscribe to to another ASM Journal go to: http://journals.asm.org/site/subscriptions/ CLINICAL MICROBIOLOGY REVIEWS, July 2008, p. 538–582 Vol. 21, No. 3 0893-8512/08/$08.00ϩ0 doi:10.1128/CMR.00058-07 Copyright © 2008, American Society for Microbiology. All Rights Reserved. Acinetobacter baumannii: Emergence of a Successful Pathogen Anton Y. Peleg,1* Harald Seifert,2 and David L. Paterson3,4,5 Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts1; Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Goldenfelsstrasse 19-21, 50935 Cologne, Germany2; University of Queensland, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia3; Pathology Queensland, Brisbane, Queensland, 4 5 Australia ; and Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania Downloaded from INTRODUCTION .......................................................................................................................................................539 MICROBIOLOGY ......................................................................................................................................................539 Historical Perspective of the Genus Acinetobacter..............................................................................................539 Current Taxonomy..................................................................................................................................................539 Species Identification .............................................................................................................................................540 Natural Habitats.....................................................................................................................................................541 MECHANISMS OF ANTIBIOTIC RESISTANCE.................................................................................................542 ␤-Lactams ................................................................................................................................................................543 http://cmr.asm.org/ Enzymatic mechanisms ......................................................................................................................................543 Nonenzymatic mechanisms................................................................................................................................545 Aminoglycosides ......................................................................................................................................................546 Quinolones ...............................................................................................................................................................546 Tetracyclines and Glycylcyclines...........................................................................................................................546 Polymyxins ...............................................................................................................................................................546 Other Antibiotics.....................................................................................................................................................547 ANTIBIOTIC SUSCEPTIBILITY TESTING FOR THE CLINICAL MICROBIOLOGY LABORATORY....547 Breakpoints for Various Antibiotics and A. baumannii.....................................................................................547 on November 25, 2011 by CONSOL.CAPES-T299093 Issues for Antibiotic Susceptibility Testing of A. baumannii ............................................................................547 Clinical Laboratory Detection of Carbapenemases ...........................................................................................549 Role of the Clinical Microbiology Laboratory in Providing Surveillance for Multidrug-Resistant A. baumannii .............................................................................................................................................................549 DEFINITIONS OF MULTIDRUG-RESISTANT ACINETOBACTER BAUMANNII..........................................549 GLOBAL EPIDEMIOLOGY OF ACINETOBACTER BAUMANNII.....................................................................549 Europe ......................................................................................................................................................................549 North America.........................................................................................................................................................550 Latin America..........................................................................................................................................................551 Africa ........................................................................................................................................................................552 Asia and the Middle East......................................................................................................................................552 Australia and Pacific Islands................................................................................................................................552 CLINICAL MANIFESTATIONS OF ACINETOBACTER BAUMANNII INFECTIONS..................................................552 Hospital-Acquired Pneumonia ..............................................................................................................................552 Community-Acquired Pneumonia.........................................................................................................................552 Bloodstream Infection ............................................................................................................................................552 Traumatic Battlefield and Other Wounds...........................................................................................................553 UTI............................................................................................................................................................................553 Meningitis ................................................................................................................................................................553 Other Manifestations .............................................................................................................................................553 CLINICAL IMPACT OF ACINETOBACTER BAUMANNII INFECTION...........................................................................553 HOST-PATHOGEN INTERACTIONS INVOLVING ACINETOBACTER ..........................................................555 INFECTION CONTROL PERSPECTIVE ..............................................................................................................556 Why Is A. baumannii a Persistent Hospital Pathogen?.....................................................................................556 Molecular Epidemiologic Techniques ..................................................................................................................557 Plasmid analysis .................................................................................................................................................557 Ribotyping............................................................................................................................................................557 PFGE ....................................................................................................................................................................557 PCR-based typing methods ...............................................................................................................................558 AFLP analysis......................................................................................................................................................558 MLST....................................................................................................................................................................558 * Corresponding author. Mailing address: Division of Infectious Diseases, Beth Israel Deaconess Medical Center and Harvard Medical School, 110 Francis Street, LMOB Suite GB, Boston, MA 02215. Phone: (617) 667-7000. Fax: (617) 632-7626. E-mail: apeleg@bidmc .harvard.edu. 538 VOL. 21, 2008 A. BAUMANNII, A SUCCESSFUL PATHOGEN 539 PCR–ESI-MS.......................................................................................................................................................558 Hospital Outbreaks and Control Measures........................................................................................................559