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Title: Severe community-acquired Acinetobacter baumannii pneumonia: An emerging highly lethal infectious disease in the Asia-Pacific
Authors: Ong, C.W.M.
Lye, D.C.B.
Khoo, K.L.
Chua, G.S.W.
Yeoh, S.F.
Leo, Y.S.
Tambyah, P.A. 
Chua, A.C.
Keywords: Acinetobacter baumannii
Community-acquired pneumonia
Systemic inflammatory response syndrome
Issue Date: Nov-2009
Citation: Ong, C.W.M., Lye, D.C.B., Khoo, K.L., Chua, G.S.W., Yeoh, S.F., Leo, Y.S., Tambyah, P.A., Chua, A.C. (2009-11). Severe community-acquired Acinetobacter baumannii pneumonia: An emerging highly lethal infectious disease in the Asia-Pacific. Respirology 14 (8) : 1200-1205. ScholarBank@NUS Repository.
Abstract: Background and objective: Patients with community-acquired Acinetobacter baumannii (AB) pneumonia have been reported from subtropical countries. We investigated the epidemiology, clinical and microbiological characteristics of community-acquired pneumonia (CAP) due to AB in Singapore. Method: A retrospective case series was performed over a 21-month period at two institutions. Results: From 1 January 2007 to 30 September 2008, eight patients were diagnosed with CAP due to AB. Seven had bacteraemia and five were sputum culture-positive. The median age at presentation was 58.5 years (range 45-76 years). Five patients (71.4%) acquired the pneumonia in the warmer months of June to September. Presentation was acute, with a median duration of 2.5 days (range 1-7 days). The median Acute Physiology and Chronic Health Evaluation II score was 28.5 (range 6-36). Six patients presented with septic shock, lactic acidosis, acute kidney injury and respiratory failure, necessitating ICU care; five of thesepatients eventually died. All patients received empirical antibiotics, including third-generation cephalosporins, which were inactive against the organism. All isolates were susceptible to ampicillin/sulbactam, ciprofloxacin, co-trimoxazole, aminoglycosides and imipenem. Conclusions: Community-acquired AB pneumonia have a fulminant course. In a region endemic for melioidosis and severe community-acquired Klebsiella pneumoniae, the challenge lies in rapid identification and initiation of appropriate empirical antibiotics to improve the survival of patients with AB CAP. © 2009 Asian Pacific Society of Respirology.
Source Title: Respirology
ISSN: 13237799
DOI: 10.1111/j.1440-1843.2009.01630.x
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