The epidemiology and control of Acinetobacter baumannii in health care facilities.

Acinetobacter baumannii is a ubiquitous pathogen capable of causing both community and health care-associated infections (HAIs), although HAIs are the most common form. This organism has emerged recently as a major cause of HAI because of the extent of its antimicrobial resistance and its propensity to cause large, often multifacility, nosocomial outbreaks. The occurrence of outbreak is facilitated by both tolerance to desiccation and multidrug resistance, contributing to the maintenance of these organisms in the hospital environment. In addition, the epidemiology of A. baumannii infection is often complex, with the coexistence of epidemic and endemic infections, the latter of which often is favored by the selection pressure of antimicrobials. The only good news is that potentially severe A. baumannii infection, such as bacteremia or pneumonia in patients in the intensive care unit who are undergoing intubation, do not seem to be associated with a higher attributable mortality rate or an increased length of hospital stay.