Clinical characteristics of patients with Acinetobacter junii infection.

BACKGROUND AND PURPOSE

Acinetobacter junii is a human pathogen but A. junii infection is rarely reported. This study aimed to delineate the characteristics of A. junii infection.

METHODS

The medical records of 34 patients who were treated at Taipei Veterans General Hospital, Taipei, Taiwan, from May 1999 to May 2007 and had A. junii isolated from sterile sites were reviewed. Isolates of A. junii were identified by using API ID 32 GN and were confirmed by analysis of the 16S-23S rRNA intergenic spacer region.

RESULTS

Thirty five infections with A. junii were identified. The most common underlying conditions included prior antibiotic use (56%), central venous catheterization (50%), and malignancy (38%). Systemic inflammatory response syndrome and shock developing within 1 week were observed in 27 (77%) and 8 (23%) episodes, respectively. Eighty percent of the infectious episodes were hospital acquired. The infections were primary bacteremia (n = 32), empyema (n = 1), peritonitis (n = 1), and keratitis (n = 1). Polymicrobial infection was present in 9 episodes (26%). A. junii isolates remained susceptible to most of the tested antimicrobial agents, but the hospital-acquired isolates had higher resistance rates than the community-acquired isolates. Four patients (11.4%) died of A. junii infection despite appropriate antimicrobial therapy for 3 patients. Shock that developed within 1 week of bacteremia was associated with a poor outcome (p = 0.01).

CONCLUSIONS

A. junii is an opportunistic pathogen that mainly affects patients who have had prior antimicrobial therapy, invasive procedures, or malignancy. Newly emerging infections caused by A. junii and the increasing antimicrobial resistance among hospital-acquired A. junii isolates should be monitored.