Acinetobacter in modern warfare

O’Shea, Matthew K.

doi:10.1016/j.ijantimicag.2012.01.018

Cited by 73 publications

(65 citation statements)

References 115 publications

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“…Another scenario in which Acinetobacter has been a major cause of infection is among wound, soft tissue, and invasive (blood and bone) infections in soldiers in Afghanistan and Iraq, particularly after traumatic injury (197,(202)(203)(204)(205)(206)(207)(208). Similar infections have occurred in trauma victims after natural disasters, such as floods and earthquakes, or bystanders in areas of active military conflicts (209)(210)(211)(212)(213)(214)(215).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Clinical and Pathophysiological Overview of Acinetobacter Infections: a Century of Challenges

et al. 2017

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SUMMARY Acinetobacter is a complex genus, and historically, there has been confusion about the existence of multiple species. The species commonly cause nosocomial infections, predominantly aspiration pneumonia and catheter-associated bacteremia, but can also cause soft tissue and urinary tract infections. Community-acquired infections by Acinetobacter spp. are increasingly reported. Transmission of Acinetobacter and subsequent disease is facilitated by the organism's environmental tenacity, resistance to desiccation, and evasion of host immunity. The virulence properties demonstrated by Acinetobacter spp. primarily stem from evasion of rapid clearance by the innate immune system, effectively enabling high bacterial density that triggers lipopolysaccharide (LPS)–Toll-like receptor 4 (TLR4)-mediated sepsis. Capsular polysaccharide is a critical virulence factor that enables immune evasion, while LPS triggers septic shock. However, the primary driver of clinical outcome is antibiotic resistance. Administration of initially effective therapy is key to improving survival, reducing 30-day mortality threefold. Regrettably, due to the high frequency of this organism having an extreme drug resistance (XDR) phenotype, early initiation of effective therapy is a major clinical challenge. Given its high rate of antibiotic resistance and abysmal outcomes (up to 70% mortality rate from infections caused by XDR strains in some case series), new preventative and therapeutic options for Acinetobacter spp. are desperately needed.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Clinical and Pathophysiological Overview of Acinetobacter Infections: a Century of Challenges

et al. 2017

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“…Colloquially, A. baumannii is referred to as 'Iraqibacter' due to its seemingly sudden emergence in military treatment facilities during the Iraq War. Soldiers in Iraq and Afghanistan reported with traumatic injuries due to gunfire and explosions suffered from chronic and life-threatening A. baumannii burn wound infections [47][48][49]. Thus, there is an urgent need to develop materials that can disrupt A. baumannii biofilms and be effective in-vivo for e.g.…”

Section: A N U S C R I P Tmentioning

confidence: 99%

Amide side chain amphiphilic polymers disrupt surface established bacterial bio-films and protect mice from chronic Acinetobacter baumannii infection

et al. 2016

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“…VAP is the most frequently reported A. baumannii infection among patients in the intensive care unit (ICU), with mortality rates ranging between 25% and 75% (1,(8)(9)(10). A. baumannii has also been associated with infections among military personnel who sustained severe combat wounds in Afghanistan and Iraq (11,12).…”

mentioning

confidence: 99%

Molecular Mechanisms of Sulbactam Antibacterial Activity and Resistance Determinants in Acinetobacter baumannii

Penwell

Shapiro

Giacobbe

et al. 2015

Antimicrob Agents Chemother

171

136

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Sulbactam is a class A ␤-lactamase inhibitor with intrinsic whole-cell activity against certain bacterial species, including Acinetobacter baumannii. The clinical use of sulbactam for A. baumannii infections is of interest due to increasing multidrug resistance in this pathogen. However, the molecular drivers of its antibacterial activity and resistance determinants have yet to be precisely defined. Here we show that the antibacterial activities of sulbactam vary widely across contemporary A. baumannii clinical isolates and are mediated through inhibition of the penicillin-binding proteins (PBPs) PBP1 and PBP3, with very low frequency of resistance; the rare pbp3 mutants with high levels of resistance to sulbactam are attenuated in fitness. These results support further investigation of the potential clinical utility of sulbactam.

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Acinetobacter in modern warfare

Cited by 73 publications

References 115 publications

Clinical and Pathophysiological Overview of Acinetobacter Infections: a Century of Challenges

Clinical and Pathophysiological Overview of Acinetobacter Infections: a Century of Challenges

Amide side chain amphiphilic polymers disrupt surface established bacterial bio-films and protect mice from chronic Acinetobacter baumannii infection

Molecular Mechanisms of Sulbactam Antibacterial Activity and Resistance Determinants in Acinetobacter baumannii

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