[caroladybelle]

What sort of treatments are you seeing for patients cultured positive with Acinetobacter baumanii, especially given the newer resistant forms that are cropping up?

I am not very familiar with treatment of this but am in increasing need of info.

[medicrnohio]

We have had several patients test positive for Acinetobacter. The cultures have showed them to be total drug resistant forms. In both cases they have stopped all antibiotics, hoping that the patient will colonize. In one case the patient died, although I don't think Acinetobacter was the cause but probably just a contributing cause. In the other case the patient fought some of it off on her own and went to an ECF.

[earle58]

hoping these links work/help.

www.emedicine.com/med/topic3456.htm

www.en.wikipedia.org/wiki/Acinetobacter

www.hopkinsmedicine.org/heic/ID/mdr/


leslie

[indigo girl]

Great links, leslie! I learned a few things...

It sounds like this a very worrisome organism with not many tx options left.

It is no wonder that anyone would be seeking more information about it.

[earle58]

Originally Posted by indigo girl

Great links, leslie! I learned a few things...

It sounds like this a very worrisome organism with not many tx options left.

It is no wonder that anyone would be seeking more information about it.

i agree, indigo, it is worrisome.
but w/the liberal use of abx over the yrs, we anticipated this type of event.
those w/compromised immunity, sounds like they have little chance.

leslie

[indigo girl]

OK, if standard antibiotic tx does not work, what about trying hyperbaric, perhaps with a drug cocktail?

These links below do not address the specific organism in the OP's post but, what have you got to lose when you have no other options?

Just thinking...

http://www.smmhc.com/DesktopDefault.aspx?tabid=145

http://healthlink.mcw.edu/article/983208928.html

http://www.ncbi.nlm.nih.gov/sites/en...t=AbstractPlus

[earle58]

i've read about hyperbaric tx.
it 'sounds' like it's ltd to dermal injuries, and the subsequent organisms that infiltrate the areas.

i got the impression that acinetobacter treatment is progressively requiring cocktails.
that they isolate, then c&s the offending bacteria, and treat accordingly to the sensitivities.
however, it does sound that hyperbaric sessions would indeed, enhance the treatment...if it can penetrate the urinary bladder, deep respiratory secretions, or any other targeted organ.

i know that 1 of the links cited its cost-effectiveness, but i do wonder...

thanks for those links!

leslie

[caroladybelle]

Originally Posted by earle58

i agree, indigo, it is worrisome.
but w/the liberal use of abx over the yrs, we anticipated this type of event.
those w/compromised immunity, sounds like they have little chance.

It is my understanding that some military from Iraq are coming back colonized with it, including resistant forms.

It was not showing up in Persian Gulf 1.

The nonresistant forms were seen in Vietnam.

I had wondered why some patients with it were not any extra ABX therapy (my patients are immunocompromised and typically on prophylactic PO ABX).

Thank you for the links.