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Acinetobacter species are Gram-negative bacilli. On non-selective agar, they show coccobacillary-morphology, in fluid media appeared as rods predominate, specifically during early growth (Bergogne-Berezin & Towner, 1996). The Acinetobacter species shows quite variable morphology, during Gram-stained human clinical specimens, and difficult to differentiate Acinetobacter from other infective agents. MacConkey agar, is mostly used for growing different strains of Acinetobacter, and called non-lactose-fermenting, because they frequently ferment lactose partially (Vasanthakumari, 2007).
1.5.1 PATHOGENESIS
Acinetobacter are known to form intracellular attachments of polyhydroxyalkanoates, during specific environmental conditions (e.g, deficiency of essential elements such as phosphorus nitrogen, and oxygen combined with an unnecessary supply of carbon sources). Acinetobacter is commonly found in water and soil. While there are many Acinetobacter species involved in the outbreaks of Acinetobacter infections. Commonly Acinetobacter species cause infections in daycare units, and healthcare settings in patients. It causes various type of diseases ranging from pneumonia, to serious blood or wound infections, and the symptoms vary depending on the disease. Acinetobacter may live in a patient without causing infection or symptoms especially in tracheostomy sites or open wounds (Boyce & Pittet, 2002).In British hospitals, the frequency of nosocomial infections in prompted, by understanding the effectiveness of anions in air purification, by installing of a negative air ionizer, airborne Acinetobacter infections rate fell to zero (White et al., 2007).

Acinetobacter is resistant to commonly used drugs. Decisions of Acinetobacter infections, treatment should be made on a case-by-case basis by a physician. Acinetobacter species are inherently resistant to many classes of antibiotics including penicillin, chloramphenicol, and often aminoglycosides (Karageorgopoulos & Falagas, 2008). Resistance of Acinetobacter to fluoroquinolones has been reported during therapy, an increased resistance to other drugs mediated through active transport, control and prevention (CDC) reported Acinetobacter resistance profile for first time (Sievert et al., 2013). Acinetobacter species are sensitive to sulbactam, which is used as a beta-lactamase inhibitor, this is sulbactam inherited property (Manenzhe, 2015).
Generally, first, second, and third-generation penicillin’s and cephalosporin’s macrolides have little or no anti-Acinetobacter activity, and they may be predispose to Acinetobacter colonizes. Some strains are sensitive to Ceftazidime, cefepime, and sulbactam containing beta-lactamase inhibitor drugs (Akova, 2008). Mono and combination therapy has been used successfully (e.g, minocycline, and amikacin). Combination therapy is often discussed and suggested (Zavascki, Bulitta, & Landersdorfer, 2013).

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