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Abstract

MDR ACINETOBACTER INFECTIONS: AN ALARMING THREAT FOR CRITICALLY ILL PATIENTS

Gopal Kumar*

ABSTRACT

Acinetobacter are a group of non-fermentative, Gram-negative coccobacilli bacteria that have minimal nutritional requirements and can survive on a variety of surfaces and aqueous environments. At present Acinetobacter is a growing public health threat affecting a considerable proportion of critically ill patients in several parts of the world. There has been increasing concern regarding the rise of Acinetobacter infections in critically ill patients. Infections caused by A. baumannii are associated with higher mortality and morbidity because of its relatively high virulence and antimicrobial resistance. Acinetobacter is a formidable challenge to managing these critically ill patients. Acinetobacter has become one of the leading cause of nosocomial infection because of the genetic capabilities to acquire resistance and partly due to high selective pressure, especially in critical care units. This pathogen's ability to rapidly develop antimicrobial resistance to all currently available antimicrobial agents is concerning because increasing data support attributable mortality to these bacteria when associated with hospitalized patients with comorbidities and severe illness. It disseminates antibiotic resistance by virtue of its extraordinary ability to accept or donate resistance plasmids. These infections most frequently involve the respiratory tract of intubated patients. The role of dual therapy is currently unclear and might be associated with increased toxicities without proven synergy or ability to prevent the development of resistance. Infection control and antibiotic control measures might have the greatest impact on these bacteria. Continued efforts are needed to develop new antimicrobial agents against this pathogen and assess the ideal amongst currently available agents.

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