Case Report: Severe Community-Acquired Pneumonia in Réunion Island due to Acinetobacter baumannii

Am J Trop Med Hyg. 2024 Jun 4;111(1):136-140. doi: 10.4269/ajtmh.23-0820. Print 2024 Jul 3.

Abstract

Acinetobacter baumannii (Ab) is a well-known nosocomial pathogen that has emerged as a cause of community-acquired pneumonia (CAP) in tropical regions. Few global epidemiological studies of CAP-Ab have been published to date, and no data are available on this disease in France. We conducted a retrospective chart review of severe cases of CAP-Ab admitted to intensive care units in Réunion University Hospital between October 2014 and October 2022. Eight severe CAP-Ab cases were reviewed. Median patient age was 56.5 years. Sex ratio (male-to-female) was 3:1. Six cases (75.0%) occurred during the rainy season. Chronic alcohol use and smoking were found in 75.0% and 87.5% of cases, respectively. All patients presented in septic shock and with severe acute respiratory distress syndrome. Seven patients (87.5%) presented in cardiogenic shock, and renal replacement therapy was required for six patients (75.0%). Five cases (62.5%) presented with bacteremic pneumonia. The mortality rate was 62.5%. The median time from hospital admission to death was 3 days. All patients received inappropriate initial antibiotic therapy. Acinetobacter baumannii isolates were all susceptible to ceftazidime, cefepime, piperacillin-tazobactam, ciprofloxacin, gentamicin, and imipenem. Six isolates (75%) were also susceptible to ticarcillin, piperacillin, and cotrimoxazole. Severe CAP-Ab has a fulminant course and high mortality. A typical case is a middle-aged man with smoking and chronic alcohol use living in a tropical region and developing severe CAP during the rainy season. This clinical presentation should prompt administration of antibiotic therapy targeting Ab.

MeSH terms

  • Acinetobacter Infections* / drug therapy
  • Acinetobacter Infections* / epidemiology
  • Acinetobacter Infections* / microbiology
  • Acinetobacter baumannii*
  • Adult
  • Aged
  • Anti-Bacterial Agents* / therapeutic use
  • Community-Acquired Infections* / drug therapy
  • Community-Acquired Infections* / epidemiology
  • Community-Acquired Infections* / microbiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pneumonia, Bacterial / complications
  • Pneumonia, Bacterial / drug therapy
  • Pneumonia, Bacterial / epidemiology
  • Pneumonia, Bacterial / microbiology
  • Respiratory Distress Syndrome / epidemiology
  • Respiratory Distress Syndrome / microbiology
  • Retrospective Studies
  • Reunion / epidemiology
  • Shock, Septic / epidemiology
  • Shock, Septic / microbiology

Substances

  • Anti-Bacterial Agents