Biochemistry

Acinetobacter haemolyticus-Introduction, Morphology, Pathogenicity, Lab Diagnosis, Treatment, Prevention, and Keynotes

Introduction


Acinetobacter haemolyticus is an aerobic, non-fermenting bacterium found in nature and hospital environments. It belongs to the Acinetobacter genus, frequently causing healthcare-associated infections. It is generally considered less virulent than Acinetobacter baumannii but is increasingly recognized in human infections. 

Morphology

  • Shape: Gram-negative coccobacilli
  • Arrangement: Pairs or short chains
  • Staining: Gram-negative
  • Motility: Non-motile
  • Colony Characteristics: Smooth, white to cream colonies on blood agar. It typically displays beta-hemolysis on blood agar, distinguishing it from non-hemolytic species.

Pathogenicity

  • Opportunistic Nature: Primarily affects immunocompromised patients or those with invasive devices (ventilators, catheters).
  • Infection Sites: It causes pneumonia (often ventilator-associated), bloodstream infections (BSIs), and infections in surgical or burn wounds.
  • Virulence Factors: Adhesins (fimbriae) for attaching to surfaces and host cells, iron-acquisition systems, and the ability to form biofilms on medical equipment.
  • Environmental Survival: Highly resilient; can survive for long periods in hospitals, contributing to persistent outbreaks.

Lab Diagnosis

  • Specimens: The common specimens are blood, urine, sputum, and wound swabs.
  • Gram Stain: Direct microscopic observation of Gram-negative coccobacilli.
  • Culture: Grows readily on blood agar (showing hemolytic colonies) and MacConkey agar (non-lactose fermenting).
Fig. Acinetobacter haemolyticus growth on CLED agar
  • Biochemical Tests: Oxidase-negative, catalase-positive, non-motile.
  • Identification: Automated systems (e.g., VITEK 2 compact) or Matrix-Assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF) mass spectrometry (VITEK-MS).

Treatment

  • Multidrug Resistance: Acinetobacter species, including Acinetobacter haemolyticus, are frequently resistant to multiple antibiotics.
  • Treatment Options: Therapy is based on susceptibility testing, with carbapenems (meropenem, imipenem) commonly used, although resistance is rising.
  • Alternative Agents: Colistin and tigecycline may be utilized for multidrug-resistant strains.

Prevention

  • Infection Control: Strict adherence to hand hygiene by healthcare staff is critical.
  • Environmental Cleaning: Enhanced cleaning and disinfection of patient rooms and equipment to eliminate environmental reservoirs.
  • Infection Control Practices: Use of transmission-based precautions (wearing gloves or gowns) and cohorting patients with known infections.

Keynotes

  • Acinetobacter haemolyticus is known for causing beta-hemolysis (hemolytic activity on blood agar).
  • High resilience allows it to persist on dry surfaces.
  • It is an increasingly important, yet sometimes overlooked, pathogen in nosocomial, especially ventilator-associated pneumonia (VAP).
  • A major issue in treatment is the increasing emergence of carbapenem resistance.

Further Readings

  • https://www.sciencedirect.com/topics/medicine-and-dentistry/acinetobacter
  • https://en.wikipedia.org/wiki/Acinetobacter_haemolyticus
  • https://www.uptodate.cn/contents/acinetobacter-infection-epidemiology-microbiology-pathogenesis-clinical-features-and-diagnosis/print
  • https://clinicalgate.com/acinetobacter-stenotrophomonas-and-similar-organisms
  • https://www.pathologyoutlines.com/topic/microbiologyacinetobacter.html
  • https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/acinetobacter
  • https://www.cdc.gov/acinetobacter/about/index.html
  • https://microbenotes.com/acinetobacter-baumannii/
  • https://www.infectiousdiseaseadvisor.com/ddi/acinetobacter
  • https://www.sciencedirect.com/science/article/pii/S1198743X14626008
  • https://www.researchgate.net/publication/49835614_Genotypic_and_phenotypic_characterization_of_the_Acinetobacter_calcoaceticus-Acinetobacter_baumannii_complex_with_the_proposal_of_Acinetobacter_pittii_sp_nov_formerly_Acinetobacter_genomic_species_3_a
  • https://www.nature.com/articles/nrmicro1789
  • https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/acinetobacter
  • https://pmc.ncbi.nlm.nih.gov/articles/PMC11925754
  • https://elibrary.tucl.edu.np/items/2deb7edb-a5ed-4519-91d7-911e194f2234

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