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Vol. 46. Issue 12.
Pages 700-710 (December 2022)
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Vol. 46. Issue 12.
Pages 700-710 (December 2022)
Update in Intensive Care Medicine: Severe infections due to multi-resistant gram-negative bacilli
Treatment of Acinetobacter baumannii severe infections
Tratamiento de infecciones graves por Acinetobacter baumannii
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R. Reinaa,
Corresponding author
rosireina@gmail.com

Corresponding author.
, C. León-Moyab, J. Garnacho-Monterob
a Cátedra Terapia Intensiva, Facultad de Medicina, Universidad Nacional de La Plata, Argentina, Sociedad Argentina de Terapia Intensiva (SATI), La Plata, Provincia de Buenos Aires, Argentina
b Unidad Clínica de Cuidados Intensivos, Hospital Universitario Virgen Macarena, Sevilla, Spain
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Abstract

Acinetobacter baumannii is a Gram-negative, multidrug-resistant (MDR) pathogen that causes nosocomial infections, especially in intensive care units (ICUs) and immunocompromised patients. A. baumannii has developed a broad spectrum of antimicrobial resistance, associated with a higher mortality rate among infected patients compared with other non-baumannii species. In terms of clinical impact, resistant strains are associated with increases in both in-hospital length of stay and mortality. A. baumannii can cause a variety of infections, especially ventilator-associated pneumonia, bacteremia, and skin wound infections, among others. The most common risk factors for the acquisition of MDR A. baumannii are previous antibiotic use, mechanical ventilation, length of ICU and hospital stay, severity of illness, and use of medical devices. Current efforts are focused on addressing all the antimicrobial resistance mechanisms described in A. baumannii, with the objective of identifying the most promising therapeutic scheme.

Keywords:
Acinetobacter
Multidrug-resistant
Infection
Pneumonia
Antibiotics
Resumen

El Acinetobacter baumannii es un patógeno Gram negativo, multirresistente (MR) que causa infecciones nosocomiales, especialmente en las Unidades de Cuidados Intensivos (UCIs) y en los pacientes inmunocomprometidos. El A. baumannii ha desarrollado una resistencia antibiótica de amplio espectro, asociada con alta tasa de mortalidad entre los pacientes infectados comparada con las otras especies de Acinetobacter no baumannii. En relación al impacto clínico, las cepas resistentes están asociadas con incremento de la estadía hospitalaria y de la mortalidad. El A. baumannii puede causar diferentes infecciones, especialmente neumonía asociada la ventilación mecánica, bacteriemia, e infección de piel y partes blandas, entre otras. Los factores de riesgo más frecuentes para la adquisición de A. baumannii MR son el uso previo de antibióticos, la asistencia respiratoria mecánica, la estadía en la UCI y en el hospital, la severidad de la enfermedad, y el uso de dispositivos médicos. Los esfuerzos actuales están focalizados en determinar todos los mecanismos de resistencia descriptos en el A. baumannii, con el objetivo de identificar esquemas terapéuticos más efectivos.

Palabras clave:
Acinetobacter
Multirresistentes
Infección
Neumonía
Antibióticos

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