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Review

Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018)

1
Friedrich-Loeffler-Institut, Institute of Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743 Jena, Germany
2
Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh 13736, Egypt
3
Institute for Infectious Diseases and Infection Control, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
4
Research Campus Infectognostics, Philosophenweg 7, 07743 Jena, Germany
*
Author to whom correspondence should be addressed.
Microorganisms 2020, 8(3), 375; https://doi.org/10.3390/microorganisms8030375
Received: 24 January 2020 / Revised: 3 March 2020 / Accepted: 3 March 2020 / Published: 6 March 2020
(This article belongs to the Section Medical Microbiology)
Acinetobacter (A.) baumannii has gained global notoriety as a significant nosocomial pathogen because it is frequently associated with multi-drug resistance and hospital-based outbreaks. There is a substantial difference in the incidence of A. baumannii infections between different countries and within Germany. However, its continuous spread within Germany is a matter of concern. A systematic literature search and analysis of the literature published between 2000 and 2018 on A. baumannii in humans was performed. Forty-four studies out of 216 articles met the criteria for inclusion, and were selected and reviewed. The number of published articles is increasing over time gradually. Case reports and outbreak investigations are representing the main body of publications. North Rhine-Westphalia, Hesse and Baden-Wuerttemberg were states with frequent reports. Hospitals in Cologne and Frankfurt were often mentioned as specialized institutions. Multiresistant strains carrying diverse resistance genes were isolated in 13 of the 16 German states. The oxacillinase blaOXA-23-like, intrinsic blaOXA-51-like, blaOXA-58 variant, blaNDM-1, blaGES-11, blaCTX-M and blaTEM are the most predominant resistance traits found in German A. baumannii isolates. Five clonal lineages IC-2, IC-7, IC-1, IC-4 and IC-6 and six sequence types ST22, ST53, ST195, ST218, ST944/ST78 and ST348/ST2 have been reported. Due to multidrug resistance, colistin, tigecycline, aminoglycosides, fosfomycin, ceftazidime/avibactam and ceftolozan/tazobactam were often reported to be the only effective antibiotics left to treat quadruple multi-resistant Gram-negative (4MRGN) A. baumannii. Dissemination and infection rates of A. baumannii are on the rise nationwide. Hence, several aspects of resistance development and pathogenesis are not fully understood yet. Increased awareness, extensive study of mechanisms of resistance and development of alternative strategies for treatment are required. One-Health genomic surveillance is needed to understand the dynamics of spread, to identify the main reservoirs and routes of transmission and to develop targeted intervention strategies. View Full-Text
Keywords: Acinetobacter baumannii; resistance development; distribution; Germany; systematic review; human Acinetobacter baumannii; resistance development; distribution; Germany; systematic review; human
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MDPI and ACS Style

Wareth, G.; Brandt, C.; Sprague, L.D.; Neubauer, H.; Pletz, M.W. Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018). Microorganisms 2020, 8, 375. https://doi.org/10.3390/microorganisms8030375

AMA Style

Wareth G, Brandt C, Sprague LD, Neubauer H, Pletz MW. Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018). Microorganisms. 2020; 8(3):375. https://doi.org/10.3390/microorganisms8030375

Chicago/Turabian Style

Wareth, Gamal, Christian Brandt, Lisa D. Sprague, Heinrich Neubauer, and Mathias W. Pletz 2020. "Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018)" Microorganisms 8, no. 3: 375. https://doi.org/10.3390/microorganisms8030375

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