Infectious Disease Compendium


A few reviews: PubMed and PubMed.


Gram negative rods (when growing) and coccobacillus (when not) and includes A. baumannii, A. haemolyticus, A. junii, A. johnsenii, A. lwoffi, A. radioresistens and 15 others.

Epidemiologic Risks

Usually a complication of hospitalization or nursing homeization (my neologism, if you use it you owe me a dollar). There is a particularly resistant strain of A. baumannii found in soldiers from Iraq and Afghanistan (PubMed) for which imipenem is the most reliable agent; may want to consider colistin. As of 2018 (Reference), however, there is little hope that our troops will be returning any time soon but the wounded can bring this bug home with them, yet another Homeland Security failure.

It is an increasing nosocomial/nursing home pathogen, often multi-drug resistant (PubMed).


Usually hospital acquired infections of all types.

Reports of community acquired pnuemonia, associated with poor hosts (they serve Bud light) and warm, wet environments (PubMed).


CID Treatment review 2010

Often resistance emerges during therapy with third generation cephalosporins, know your local susceptibilities. Generally imipenem/meropenem, cefepime, and ciprofloxacin are the best bet. However, resistant A. baumannii are rapidly increasing, in some areas as of 2006 as high as 40% resistant to beta lactams.

For the MDR strains, consider tigecycline (PubMed) and colistin, amikacin, or minocycline (PubMed), which is not better or worse than tobramycin for efficacy or toxicity (Reference). Carbapenem resistant organisms may be treated best with ampicillin/sulbactam (oddly it is susceptible to the sulbactam component of Unisin) > colistin (PubMed). Resistance may develop to tigecycline while on therapy (PubMed).

In vitro, colistin/meropenem, colistin/rifampicin, colistin/minocycline, and minocycline/meropenem are synergistic (Reference).

For colistin resistant, perhaps the the best option is colistin, a carbapenem, and ampicillin-sulbactam (PubMed ).

Although in a randomized clinical trial, rifampin added nothing to colistin (PubMed) nor does adding meropenam (PubMed).


Usually sensitive to third generation cephalosporins,carbapenems, and quinolones.

As to its name, it means non-moving (akinetic)and the Wikipedia notes "The first element acineto-appears as a somewhat baroque rendering of the Greek morpheme ακίνητο-, commonly transliterated in English is akineto-, but actually stems from the French cinetique and was adopted directly into English."

Curious Cases

Relevant links to my Medscape blog

I know it when I see it

A First I Did Not Want

Sleepy Head

Any Bug in Any Place

Man Oh Man

Last Update 5/03/18.