Chapter 22BACTERIA

Christopher J. Martin, Aletheia S. Donahue, and John D. Meyer

ACINETOBACTER SPECIES

Common name for disease: None

Occupational setting

Acinetobacter species are ubiquitous in nature. They are commonly isolated from work settings with moist environments and microenvironments (e.g., swine confinement buildings,1 wastewater treatment plants,2 composting plants,3 poultry-processing plants,4 cotton mills,5 metal-working operations,6 and bakeries.7)

Exposure (route)

Inhalation is the main route of exposure in the occupational setting.

Pathobiology

Acinetobacter species, particularly Acinetobacter baumannii and the closely related species A. pittii and A. nosocomialis, are among the most common causes of healthcare-associated pneumonia and other infections, particularly in intensive care unit (ICU) settings and long-term care facilities.8 Patient-to-patient transmission is frequent in such outbreaks, with isolated case reports of transmission to healthcare workers.9 The number of isolates in healthcare settings increases during times of conflict and following natural disasters, with recent large outbreaks involving soft-tissue infections among previously healthy US soldiers wounded in Afghanistan and Iraq.10

These organisms rarely cause infection outside of the clinical setting. Community-acquired pneumonia has been described in persons with cancer and alcoholism, with a preponderance of case reports during warm, humid months and from Asia and Australia.8

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