[Acinetobacter baumannii pandrug-resistant: update in epidemiological and antimicrobial managing issues].
In the last two decades Acinetobacter baumannii has emerged as a major relevant world nosocomial pathogen. A. baumannii can be a causal agent of diseases like pneumonia, bacteremia, meningitis, soft tissue and urinary tract infections, associating to high mortality. Several national and foreign communications reveal the isolation of A. baumannii resistant to almost all commercially available antimicrobial agents, drastically limiting the therapeutic options. To optimize the therapy of these infections, the need of development of new antibacterial agents is raised as is the revival of certain forgotten compounds, as the polymyxins. In order to check and evaluate the information on the management of multi-resistant A. baumannii infections, we performed a systematical review of the medical scientific literature, that included Medline and LILACS, identifying and categorizing the clinical relevancy of the sources gathered to the date of this investigation. Clinically relevant epidemiological aspects, microbiological information and clinical studies in patients with pandrug (AB-PDR) or multidrug resistant (AB-MDR) A. baumannii infections were reviewed. The response adapted to the management of AB-PDR infection is complex, its eradication needs adherence to suitable practices of infection control and the prudent and effective use of antimicrobial therapy. Potential options of therapy could be colistin, betalactam associations with sulbactam and tetracyclines, but there are no random and controlled studies in the matter.
Diomedi
Alexis
A
Instituto Nacional de Oncología, Unidad de Infectología, Hospital Del Salvador. adiomedip@entelchile.net
D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002986:Clinical Trials as Topic; D003428:Cross Infection / Q000517:prevention & control; D004195:Disease Models, Animal; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects / Q000235:genetics; D006801:Humans; D008826:Microbial Sensitivity Tests
D000900:Anti-Bacterial Agents