Acinetobacter spp in a Third World Country with Socio-economic and Immigrants Challenges

J Infect Dev Ctries. 2019 Nov 30;13(11):948-955. doi: 10.3855/jidc.11341.

Abstract

Introduction: In the last decade, Acinetobacter species have taken a major public health concern. This is mainly due the increased resistance to a wide range of antibiotics causing treatment challenges. In view of the constant population mobilization and the economic crisis that Lebanon is currently facing, it becomes a necessity to re-evaluate the real threat of Acinetobacter spp and its implication in the one health.

Methodology: This review was conducted through the analysis of 45 research papers and reports pertaining to Acinetobacter spp performed in Lebanon. More than 82% of the papers consulted were published in international journals and more than 70 percent of them had received impact factor.

Results: An in depth description of the involvement of this organism in human infection and its role as potential pathogen or simple colonizer was performed. In addition, the different aspects of resistance, mostly to carbapenems and colistin was studied and summarized. While in animals and environment, susceptible strains were mostly isolated, OXA-23/OXA-24 were predominant in humans. Recently, NDM-1 producing Acinetobacter spp was detected in a Syrian refugee which then was reported in Lebanese patients. The bacterial identification procedures are non-systematic and not always reliable in the Lebanese studies presenting sometimes discrepancies an inconsistency.

Conclusion: Acinetobacter is commonly isolated Lebanon. In view of the spread of resistance among these isolated and their dissemination, Infection control measures attempting to control the spread of this genus in and outside hospitals are lacking and thus require more attention and stewardship activities.

Keywords: Acinetobacter; Oxacillinases; bacterial resistance; carbapenems; epidemiology.

Publication types

  • Review

MeSH terms

  • Acinetobacter / drug effects*
  • Acinetobacter / isolation & purification
  • Acinetobacter / pathogenicity
  • Acinetobacter Infections / drug therapy*
  • Acinetobacter Infections / epidemiology*
  • Acinetobacter Infections / microbiology
  • Acinetobacter Infections / veterinary
  • Acinetobacter baumannii / pathogenicity
  • Animals
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Carbapenems / pharmacology
  • Carbapenems / therapeutic use
  • Developing Countries
  • Drug Resistance, Bacterial
  • Emigrants and Immigrants
  • Humans
  • Lebanon / epidemiology
  • Socioeconomic Factors

Substances

  • Anti-Bacterial Agents
  • Carbapenems