Bacteremia with Acinetobacter species--clinicopathological characteristics of 27 cases

Abstract

Acinetobacter spp. are non-fermented gram-negative rods that are widespread in the environment and colonize in the human skin. They are known to be a nosocomial pathogen causing, pneumonia, meningitis and bacteremia. Recently, they have been found increasingly in catheter-related infections (CRI). Thirty-seven cases of bacteremia were developed in our hospital during the past five years. Of these 27 cases were chosen out of the medical records for discussion in this paper. Twenty-three cases are blood positive for Acinetobacter anitratus and 4 cases for A. lwoffii. Most cases have an underlying disease like hematological malignancy, solid tumor and infantile congenital abnormality. There were also some clinical signs; high fever, hypotension, tachycardia, tachypnea, peripheral cyanosis. A central venus catheter was inserted in 22 cases, and in 13 of these, the catheter was removed after the bacteremic episode. Nine cases became afebrile after the removal of the catheter and A. anitratus was isolated from the catheter tip in four cases. Heparin was administered through the catheter in 7 cases. Formerly Acinetobacter spp. were not recognized as a major pathogen, but recently found increasingly in CRI. We also found 9 cases which were definitely diagnosed or suspected as CRI, and were successfully treated by removal of the central venus catheter. Association between administration of heparin and bacteremia of Acinetobacter spp. was reported, we actually detected such association in 7 cases, but the potential role of heparin has not been clarified yet. Compared with A. lwoffii, A. anitratus were resistant to many drugs, but had good susceptibility to imipenem, minocycline, aminoglycoside, and fluoroquinolone.(ABSTRACT TRUNCATED AT 250 WORDS)