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

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