Abstract
In the last decade, Acinetobacter species have taken a major public health concern. This is mainly due the increased resistance to a wide range of antibiotics causing treatment challenges. In view of the constant population mobilization and the economic crisis that Lebanon is currently facing, it becomes a necessity to re-evaluate the real threat of Acinetobacter spp and its implication in the one health. This review was conducted through the analysis of 45 research papers and reports pertaining to Acinetobacter spp performed in Lebanon. More than 82% of the papers consulted were published in international journals and more than 70 percent of them had received impact factor. An in depth description of the involvement of this organism in human infection and its role as potential pathogen or simple colonizer was performed. In addition, the different aspects of resistance, mostly to carbapenems and colistin was studied and summarized. While in animals and environment, susceptible strains were mostly isolated, OXA-23/OXA-24 were predominant in humans. Recently, NDM-1 producing Acinetobacter spp was detected in a Syrian refugee which then was reported in Lebanese patients. The bacterial identification procedures are non-systematic and not always reliable in the Lebanese studies presenting sometimes discrepancies an inconsistency. Acinetobacter is commonly isolated Lebanon. In view of the spread of resistance among these isolated and their dissemination, Infection control measures attempting to control the spread of this genus in and outside hospitals are lacking and thus require more attention and stewardship activities.
Highlights
IntroductionThe dissemination of antimicrobial resistance in Gram-negative bacilli (GNB) has caused major public health challenges worldwide [1]
In the last decade, Acinetobacter species have taken a major public health concern
A recent nationwide study done by the Lebanese Society of Infectious Diseases (LSID) has shown that the rate of imipenem resistance in Acinetobacter species have significantly increased from 57.6% in 2011 to 84.5% in
Summary
The dissemination of antimicrobial resistance in Gram-negative bacilli (GNB) has caused major public health challenges worldwide [1]. In their study, Kanafani et al showed that among the most common organisms causing ventilator associated pneumonia were A. anitratus It is the same as A. baumannii and Pseudomonas aeruginosa; the difference between the number of isolates was not significant (11 vs 8 isolates, respectively) [16]. The majority of the clinical laboratories perform biochemical identification This methodology has poor specificity and cannot differentiate between different Acinetobacter species including A. baumannii, A. pittii, A. nosocomialis and A. calcoaceticus [6]. The accurate identification of Acinetobacter spp is instrumental for the appropriate management of the infection and for a more rational judgement of the real threat imposed by baumannii and non baumannii Acinetobacter as per the prevalence, clinical outcome and level of antibiotic resistance
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