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Molecular Epidemiology of Acinetobacter Species

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Acinetobacter Biology and Pathogenesis

Part of the book series: Infectious Agents and Pathogenesis ((IAPA))

Abstract

In the past decades, there has been an increasing interest in the molecular epidemiology of bacteria. Data generated by a variety of phenotypic and genotypic methods can be used to identify the routes of transmission, both in a localized outbreak situation as well as in interhospital or cross-country spread.

To date, there are three clinically important Acinetobacter species: Acinetobacter baumannii and the unnamed Acinetobacter genomic species 3 and 13TU. Among those, A. baumannii is the most significant nosocomial pathogen especially in patients with impaired host defenses in the intensive care unit, and has been implicated in nearly all kinds of infections including severe nosocomial infections such as bloodstream infection (BSI), pneumonia, and meningitis. In those infections, mortality rates as high as 64% have been reported. Similar to methicillin-resistant Staphylococcus aureus (MRSA), major epidemiologic features of these organisms include their propensity for clonal spread, their involvement in hospital outbreaks as well as resistance to multiple antimicrobial agents.

Only after 1986, when the taxonomy of the genus Acinetobacter was revised and molecular methods provided the necessary tools to identify Acinetobacter at the species level, detailed studies of the epidemiology of the different members of this genus became possible.

Among the variety of molecular methods developed, some – such as plasmid profile analysis and pulsed-field gel electrophoresis (PFGE) – could be used for typing purposes only, while others – such as ribotyping and AFLP – were primarily developed for species identification. To the present day, PFGE remains the gold standard for epidemiological strain typing not only for Acinetobacter species but also for bacteria in general. PCR-based methods – such as randomly amplified polymorphic DNA-PCR (RAPD-PCR) and repetitive extragenic palindromic (REP) PCR – are generally not only easier to perform and less expensive, but they also tend to be less discriminative and less reproducible.

Molecular typing methods have provided important information on the hospital epidemiology of A. baumannii and also, to a far lesser extent, on the epidemiology of other Acinetobacter species. Insights gained through these methods included the mode of spread and the role of hospital personnel and environmental surfaces in their transmission. Outbreaks of A. baumannii involving patients within the same unit, the same hospital, or even different hospitals, cities or countries have been documented.

With the application of newer, sequence-based methods such as multi-locus sequence typing (MLST) or PCR/electrospray ionization mass spectrometry (PCR/ESI-MS) to A. baumannii, further insight into the population structure of A. baumannii might be gained. In addition, pending questions such as whether there are a few predominant clonal lineages that are responsible for the epidemic spread of multidrug-resistant A. baumannii within hospitals and across countries might be answered in the near future.

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  1. Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Goldenfelsstrasse 19-21, 50935 Cologne, Germany

    Hilmar Wisplinghoff & Harald Seifert

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    Eugénie Bergogne-Bérézin (Editor-in-Chief of Antibiotiques) (Editor-in-Chief of Antibiotiques)

  2. University of South Florida, College of Medicine, Tampa, Florida, USA

    Herman Friedman

  3. University of Pisa, Pisa, Italy

    Mauro Bendinelli

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Wisplinghoff, H., Seifert, H. (2008). Molecular Epidemiology of Acinetobacter Species. In: Bergogne-Bérézin, E., Friedman, H., Bendinelli, M. (eds) Acinetobacter Biology and Pathogenesis. Infectious Agents and Pathogenesis. Springer, New York, NY. https://doi.org/10.1007/978-0-387-77944-7_4

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