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      Severe Community-Acquired Pneumonia due to Acinetobacter baumannii in North America: Case Report and Review of the Literature

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          Abstract

          Acinetobacter baumannii is a rare but emerging cause of fulminant community-acquired pneumonia (CAP-AB). We describe a patient from a rural area who developed acute respiratory distress syndrome and septic shock. We describe risk factors and characteristics of this syndrome and review published cases of CAP-AB from North America.

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          Community-acquired Acinetobacter baumannii: clinical characteristics, epidemiology and pathogenesis.

          Carina Dexter, Gerald L Murray, Ian T. Paulsen … (2015)
          Community-acquired Acinetobacter baumannii (CA-Ab) is a rare but serious cause of community-acquired pneumonia in tropical regions of the world. CA-Ab infections predominantly affect individuals with risk factors, which include excess alcohol consumption, diabetes mellitus, smoking and chronic lung disease. CA-Ab pneumonia presents as a surprisingly fulminant course and is characterized by a rapid onset of fever, severe respiratory symptoms and multi-organ dysfunction, with a mortality rate reported as high as 64%. It is unclear whether the distinct clinical syndrome caused by CA-Ab is because of host predisposing factors or unique bacterial characteristics, or a combination of both. Deepening our understanding of the drivers of overwhelming CA-Ab infection will provide important insights into preventative and therapeutic strategies.
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            Reservoirs of Acinetobacter baumannii outside the hospital and potential involvement in emerging human community-acquired infections.

            Olivier Belmonte, Marie Kempf, Laure Guillou … (2013)
            The objective of the present report was to review briefly the potentially community-acquired Acinetobacter baumannii infections, to update information on the reservoirs of A. baumannii outside the hospital, and to consider their potential interactions with human infections. Most reports on potentially community-acquired A. baumannii have been published during the last 15 years. They concern community-acquired pneumonia, infections in survivors from natural disasters, and infected war wounds in troops from Iraq and Afghanistan. Although the existence of extra-hospital reservoirs of A. baumannii has long been disputed, the recent implementation of molecular methods has allowed the demonstration of the actual presence of this organism in various environmental locations, in human carriage, in pets, slaughter animals, and human lice. Although the origin of the A. baumannii infections in soldiers injured in Southwestern Asia is difficult to determine, there are some arguments to support the involvement of extra-hospital reservoirs in the occurrence of community-acquired infections. Overall, the emergence of community-acquired A. baumannii infections could be associated with interactions between animals, environment, and humans that are considered to be potentially involved in the emergence or re-emergence of some infectious diseases. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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              Attributable mortality of Acinetobacter baumannii: no longer a controversial issue

              Matthew E. Falagas, Petros Rafailidis (2007)
              There has been controversy regarding the mortality directly attributed to Acinetobacter baumannii infections. Data from six case–control studies have been recently added to the literature regarding the attributable mortality of A. baumannii infections during the past months. The information from these studies, added to the previous knowledge on this issue, provides evidence that A. baumannii infections are indeed associated with increased mortality. In addition, there is relevant evidence from studies examining the effect of inappropriate treatment on mortality; specifically, inappropriate treatment of A. baumannii infections has been associated with excess mortality. We believe that the accumulated data suggest that attributable mortality due to A. baumannii infections should no longer be a controversial issue. The efforts of the scientific community interested in this pathogen should therefore be directed to the development and introduction of new antibiotics effective against multidrug-resistant and pandrug-resistant A. baumannii as well as the implementation of infection control measures that may help us in the control of the increasing problem of A. baumannii infections.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Open Forum Infect Dis
                Journal ID (iso-abbrev): Open Forum Infect Dis
                Journal ID (publisher-id): ofid
                Title: Open Forum Infectious Diseases
                Publisher: Oxford University Press (US )
                ISSN (Electronic): 2328-8957
                Publication date Collection: March 2018
                Publication date (Electronic): 10 March 2018
                Publication date PMC-release: 10 March 2018
                Volume: 5
                Issue: 3
                Electronic Location Identifier: ofy044
                Affiliations
                [1 ]Division of Infectious Diseases, Department of Medicine, Atlanta, Georgia
                [2 ]Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
                Author notes
                Correspondence: D. P. Serota, MD, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, 49 Jesse Hill Jr Drive, SE, Atlanta, GA 30303 ( dserota@ 123456emory.edu ).
                Article
                Publisher ID: ofy044
                DOI: 10.1093/ofid/ofy044
                PMC ID: 5846288
                PubMed ID: 29564365
                SO-VID: e1abe03e-34d0-4fee-accd-48413c0399df
                Copyright © © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                Date received : 23 November 2017
                Date accepted : 04 March 2018
                Page count
                Pages: 3
                Funding
                Funded by: National Institutes of Health 10.13039/100000002
                Award ID: UL1TR002378
                Award ID: TL1TR002382
                Categories
                Subject: Brief Report

                Keywords: acinetobacter baumannii,community-acquired pneumonia
                Data availability:
                Keywords: acinetobacter baumannii, community-acquired pneumonia

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