Thursday February 23, 2006
Community-Acquired Acinetobacter baumannii Pneumonia !
As we are seeing more and more nosocomial infections moving out in community, recently chest has reported the largest series of CAP-AB (community-acquired pneumonia - Acinetobacter baumannii ) - and comparing its severity to HAP-AB (hospital-acquired pneumonia -Acinetobacter baumannii). 19 cases of CAP-AB has been compared to 74 cases of HAP-AB. Risk factors for CAP-AB were ever-smokers and COPD patients. It was characterized by more positive blood cultures (31.6% vs 0%), a higher frequency of ARDS (84.2% vs 17.6%), and DIC (57.9% vs 8.1%). The median survival time was only 8 days in the CAP-AB group vs 103 days in the HAP-AB group (p = 0.003). CAP-AB described to have a fulminant course, with an acute onset of dyspnea, cough, and fever that rapidly progresses to respiratory failure and shock. As discussed further in article, it may be important to consider empirical coverage for CAP-AB with presence of risk factors.
Earlier series of 13 patients were studied and read this interesting conclusion: "A baumannii should be considered as a possible etiologic agent in community-acquired lobar pneumonia when (1) patients with a fulminant course present during the warmer and more humid months of the year, and (2) patients are younger alcoholics".
Referencss: Click to get abstract/article (second popup overrides first popup)
1. Fulminant Community-Acquired Acinetobacter baumannii Pneumonia as a Distinct Clinical Syndrome - Chest. 2006;129:102-109
2. Severe Community-Acquired Pneumonia due to Acinetobacter baumannii Chest. 2001;120:1072-1077