Acinetobacter wound infection received just one antimicrobial, generally for 10-16 days. All patients responded to therapy. Their followup had lasted a mean of 9 months (range, 1-23 months) at the time the report was published.

TABLE 4.15 Type of Acinetobacter Infection in 23 Wounded Soldiers Admitted to BAMC, March 2003-May 2004, and Therapies Received

Type of Infection

No. cases

Acinetobacter osteomyelitis

15

Acinetobacter osteomyelitis with bacteremia

3

Acinetobacter burn infection

2

Acinetobacter deep wound infection

3

SOURCE: Davis et al. 2005.

TABLE 4.16 Antimicrobial Drug Susceptibilities for 38 Isolates of Acinteobacter calcoaceticu-baumannii Complex Recovered from Wound or Blood Cultures

Antimicrobial Drug

Percentage of Susceptible Isolates

Amikacin

48

Amoxicillin/clavulanate

9

Ampicillin/sulbactam

50

Cefepime

14

Cefotetan

3

Ceftazidime

12

Ceftriaxone

6

Ciprofloxacin

11

Colistina

100

Gentamicin

8

Imipenem

89

Tobramycin

14

Trimethoprim/sulfamethoxazole

29

a Colistin susceptibility evaluated in three multiple-drug-resistant isolates.

SOURCE: Davis et al. 2005.

Case Series 2:
Walter Reed Army Medical Center and Landstuhl Regional Medical Center

Scott and colleagues report the identification of A. baumannii bloodstream infections in 102 patients at five military hospitals where active-duty military personnel injured in OEF or OIF received treatment (CDC 2004c). The cases were identified from January 1, 2002, to August 31, 2004. Table 4.17 displays the number of infected patients per hospital, their age range, and the subset who that been admitted with (mostly traumatic) injuries associated with OEF or OIF. At both WRAMC and LRMC, clinicians identified a significant percentage of A. baumannii bloodstream infections associated with activities in OEF or OIF within 48 hours of admission (62% at WRAMC and 67% at LRMC). The 78 A. baumanii isolates obtained from patients at WRAMC and LRMC manifested varied levels of resistance to antimicrobial agents commonly used to treat such infections (Table 4.18).



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