REVIEW 10.1111/j.1469-0691.2004.00942.x Antimicrobial resistance of Acinetobacter spp. in Europe M. Van Looveren 1 , H. Goossens 1,2,3 and the ARPAC Steering Group* 1 Department of Medical Microbiology, University Hospital Antwerp, UA, Antwerp, Belgium and 2 ESCMID Study Group for Antimicrobial Resistance Surveillance (ESGARS), 3 Department of Medical Microbiology, Leiden University Medical Center, The Netherlands ABSTRACT Bacteria of the genus Acinetobacter are ubiquitous in nature. These organisms were invariably susceptible to many antibiotics in the 1970s. Since that time, acinetobacters have emerged as multiresistant opportunistic nosocomial pathogens. The taxonomy of the genus Acinetobacter underwent extensive revision in the mid-1980s, and at least 32 named and unnamed species have now been described. Of these, Acinetobacter baumannii and the closely related unnamed genomic species 3 and 13 sensu Tjernberg and Ursing (13TU) are the most relevant clinically. Multiresistant strains of these species causing bacteraemia, pneumonia, meningitis, urinary tract infections and surgical wound infections have been isolated from hospitalised patients worldwide. This review provides an overview of the antimicrobial susceptibilities of Acinetobacter spp. in Europe, as well as the main mechanisms of antimicrobial resistance, and summarises the remaining treatment options for multiresistant Acinetobacter infections. Keywords Acinetobacter, antimicrobial resistance, carbapenems, Europe, review, surveillance Accepted: 26 January 2004 Clin Microbiol Infect 2004; 10: 684–704 SEARCH STRATEGY AND SELECTION CRITERIA Data for this review were obtained through searches of Medline and Pubmed, from references cited in relevant articles, through searches of abstracts and posters presented at different na- tional and international meetings, from the world- wide web, and from surveillance studies, associated with the introduction of new agents, conducted by the pharmaceutical industry. Search terms used were ‘Acinetobacter’, ‘antimicrobial resistance’, ‘antibiotics’, ‘carbapenems’, ‘amino- glycosides’, ‘quinolones’ and ‘treatment’. Only studies published in English, French, German or Dutch were reviewed. The first phase of the literature search resulted in the identification of > 3500 references, but initial review of the abstracts revealed that many articles were dupli- cated across the different search strategies. After exclusion of duplicate references, 2158 studies published between 1963 and 2003 remained. Of these, 267 were downloaded for detailed review. THE ACINETOBACTER GENUS AND CLINICALLY IMPORTANT SPECIES Acinetobacter spp. are glucose-non-fermentative, non-fastidious, strictly aerobic Gram-negative coccobacilli, usually occurring in diploid forma- tion, or in chains of variable length. They are non- motile, catalase-positive and oxidase-negative [1]. Since 1986, the taxonomy of the genus Acinetob- acter has undergone extensive revision. The ori- ginal single species named Acinetobacter Corresponding author and reprint requests: M. Van Looveren, Department of Medical Microbiology, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, B-2610 Wilrijk, Belgium E-mail: [email protected] *Members of the ARPAC Steering Group are: F. Baquero (Madrid, Spain), J. Bruce (Aberdeen, UK), B. Cookson (London, UK), G. Cornaglia (Verona, Italy), L. Dijkshoorn (Leiden, The Netherlands), H. Goossens (Antwerp, Bel- gium), I. Gould (Aberdeen, UK), G. Kahlmeter (Vaxjo, Sweden), V. Krcmery (Bratislava, Slovak Republic), D. Monnet (ad hoc) (Copenhagen, Denmark), F. MacKenzie (Aberdeen, UK), J. Mollison (Aberdeen, UK), M. Struelens (Brussels, Belgium), K. Towner (Nottingham, UK), P. J. van den Broek (Leiden, The Netherlands), J. van der Meer (Nijmegen, The Netherlands), M. Van Looveren (Antwerp, Belgium), J. Vila (Barcelona, Spain), A. Voss (ad hoc) (Nijmegen, The Netherlands) and D. Wagner (Brussels, Belgium). Ó 2004 Copyright by the European Society of Clinical Microbiology and Infectious Diseases
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Related Documents
