Clinical characteristics of patients with Acinetobacter junii infection
Yu-Tse Hung, Yi-Tzu Lee, Ling-Ju Huang, Te-Li Chen, Kwok-Woon Yu, Chang-Phone Fung, Wen-Long Cho, Cheng-Yi Liu
Division of Infectious Diseases, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei; Division of Infectious Diseases, Department of Internal Medicine, Ho-Ping Branch, Taipei City Hospital, Taipei; Institute of Tropical Medicine, School of Medicine, National Yang-Ming University, Taipei; and Chutung Veterans Hospital, Chutung, Taiwan
Received: January 1, 2008 Revised: May 15, 2008 Accepted: July 31, 2008
Background and purpose:
Acinetobacter junii is a human pathogen but A. junii infection is rarely reported. This study aimed to delineate the characteristics of A. junii infection.
The medical records of 34 patients who were treated at Taipei Veterans General Hospital, Taipei, Taiwan, from May 1999 to May 2007 and had A. junii isolated from sterile sites were reviewed. Isolates of A. junii were identified by using API ID 32 GN and were confirmed by analysis of the 16S-23S rRNA intergenic spacer region.
Thirty five infections with A. junii were identified. The most common underlying conditions included prior antibiotic use (56%), central venous catheterization (50%), and malignancy (38%). Systemic inflammatory response syndrome and shock developing within 1 week were observed in 27 (77%) and 8 (23%) episodes, respectively. Eighty percent of the infectious episodes were hospital acquired. The infections were primary bacteremia (n = 32), empyema (n = 1), peritonitis (n = 1), and keratitis (n = 1). Polymicrobial infection was present in 9 episodes (26%). A. junii isolates remained susceptible to most of the tested antimicrobial agents, but the hospital-acquired isolates had higher resistance rates than the community-acquired isolates. Four patients (11.4%) died of A. junii infection despite appropriate antimicrobial therapy for 3 patients. Shock that developed within 1 week of bacteremia was associated with a poor outcome (p = 0.01).
A. junii is an opportunistic pathogen that mainly affects patients who have had prior antimicrobial therapy, invasive procedures, or malignancy. Newly emerging infections caused by A. junii and the increasing antimicrobial resistance among hospital-acquired A. junii isolates should be monitored.
Acinetobacter; Acinetobacter infections; Disease attributes; Epidemiology
J Microbiol Immunol Infect. 2009;42:47-53.