Overview of glucose nonfermenters

Acinetobacter

32 spp
15 Species cause human infection:

Genospecies	Spp.
1	Calcoacetious
2	Baumanii
4	Haemolyticus
5	Junii
7	Johnsonii
8	Lwofii
12	Radioresistens
Other	beijerinckii, bereziniae, gyllenbergii, nosocomialis, parvus, pittii, schindleri, ursingii

<aside> 💡

Acinetobacter calcoaceticus–baumannii complex, includes:

Acinetobacter baumannii
Acinetobacter pittii
Acinetobacter nosocomialis
Acinetobacter calcoaceticus </aside>

| Site | - Environment (Soil, Water)

Fomites (good @ colonising wet surfaces, resistant to some disinfectants)
Colonised HCWs (Wet skin) —> ITUs | | --- | --- | | Risk Factors | Hospital
ITU admission / Stormy admissions
Lines
TPN
ABx

Community

Lung disease (Esp in smokers)
Alcoholic
Diabetes mellitus
Tropical regions (common cause LRTI) | | Pathogenic mechanisms | Not v pathological; mostly causes nosocomial illness | | Clinical syndromes | - Chest: o VAP/HAP (NB: 80% isolates are MDR) o CAP (tropical) o Tracheobronchitis (child)
CAUTI
CNS infection (Esp if prosthetic material e.g. VAD)
SSTI o Burns o PWID
BSI (normally from chest or IV line) |

Lab diagnostic

Bug:
- GNB – but Gram variable
- Short plump coccobacilli
- Many are capsular
- Nonmotile
- Ox- / Cat+
Agar: Aerobic
Colony:
- Yellow to greyish white
- Mucoid
- haemolyticus = haemolytic on blood agar
Species ID
- Biochemical: Ox- GNB, glucose nonfermenting
- MALDI
- PCR:
  - 16S RNA PCR
  - GyrB gene
- WGS

SMI Flowchart for Nonfermentor identification

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Treatment

Beta-lactams:
- Sulbactam (Either Amp-Sulb or Sulb-Durlo)
- PipTaz
- Cefotax/Ceftriax/Ceftaz, Cefepime
- Cefiderocol
- Carbapenem (Not Erta)
Tetracyclines (Doxy, Mino)
Aminoglycosides
Quinolone (Cipro, Levo)
Cotrim
Colistin

Breakpoints for CLSI and EUCAST (as of 2023) are below: