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Review
. 2025 Jan 10:15:1519906.
doi: 10.3389/fmicb.2024.1519906. eCollection 2024.

An integrative review on the risk factors, prevention, and control strategies for carbapenem-resistant Acinetobacter baumannii colonization in critically ill patients

Shihan Zhang #  1   2 , Jie Xiao #  1   2 , Yanan Li  1   2 , Wei Li  3 , Yihui Li  1   2 , Mingmin Pang  1   2 , Meichen Yan  1   2 , Hui Han  1   2 , Yi Cui  1   2 , Xuehai Zhang  1   2 , Hao Wang  1   2
Affiliations
Review

An integrative review on the risk factors, prevention, and control strategies for carbapenem-resistant Acinetobacter baumannii colonization in critically ill patients

Shihan Zhang et al. Front Microbiol. .

Abstract

The presence of carbapenem-resistant Acinetobacter baumannii (CRAb) has become one of the leading causes of life-threatening, hospital-acquired infections globally, especially with a notable prevalence in intensive care units (ICUs). The cross-transmission of microorganisms between patients and the hospital setting is crucial in the development of CRAb colonization and subsequent infections. Recent studies indicate that colonization typically precedes infection, suggesting the effectiveness and necessity of preventing CRAb colonization as a primary method to lower infection risks. As CRAb infections tend to draw more attention due to their severe symptoms and poor outcomes, understanding the link between colonization and infection is equally vital. To establish a foundation for prevention and control strategies against CRAb colonization in ICUs, we present a comprehensive review of research pertaining to CRAb in ICUs. This encompasses an analysis of the resistance mechanisms and epidemiological characteristics of CRAb, a discussion on associated risk factors, adverse outcomes, and an evaluation of detection methods and preventive strategies.

Keywords: CRAb; colonization; hazard; prevention; risk factors.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Common colonization sites of CRAb in the human body.
FIGURE 2
FIGURE 2
Risk factors of CRAb colonization. The figure shows main factors for the occurrence and dissemination of colonization events.
FIGURE 3
FIGURE 3
Multiple mechanisms of CRAb from colonization to infection. The figure illustrates the mechanisms involved in CRAb from colonization to infection, including bacterial invasiveness and toxicity (iron uptake, siderophore, immune evasion, and biofilm formation), immunosuppression, multisite colonization, burden of comorbidities and mechanical ventilation, etc.
FIGURE 4
FIGURE 4
Proposal bundle to prevent CRAb colonization. The figure summarized four aspects of preventive measures.
See this image and copyright information in PMC

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References

    1. Abelenda-Alonso G., Padullés A., Rombauts A., Gudiol C., Pujol M., Alvarez-Pouso C., et al. (2020). Antibiotic prescription during the COVID-19 pandemic: A biphasic pattern. Infect. Control Hosp. Epidemiol. 41 1371–1372. - PMC - PubMed
    1. Agarwal S., Kakati B., Khanduri S., Gupta S. (2017). Emergence of carbapenem resistant non-fermenting gram-negative bacilli isolated in an ICU of a tertiary care hospital. J. Clin. Diagn. Res. 11 Dc04–Dc07. 10.7860/jcdr/2017/24023.9317 - DOI - PMC - PubMed
    1. Agustí C., Pujol M., Argerich M. J., Ayats J., Badía M., Domínguez M. A., et al. (2002). Short-term effect of the application of selective decontamination of the digestive tract on different body site reservoir ICU patients colonized by multi-resistant Acinetobacter baumannii. J. Antimicrob. Chemother. 49 205–208. 10.1093/jac/49.1.205 - DOI - PubMed
    1. Alfandari S., Gois J., Delannoy P. Y., Georges H., Boussekey N., Chiche A., et al. (2014). Management and control of a carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit. Med. Mal. Infect. 44 229–231. - PubMed
    1. Al-Hamad A., Pal T., Leskafi H., Abbas H., Hejles H., Alsubikhy F., et al. (2020). Molecular characterization of clinical and environmental carbapenem resistant Acinetobacter baumannii isolates in a hospital of the Eastern Region of Saudi Arabia. J. Infect. Public Health 13 632–636. 10.1016/j.jiph.2019.08.013 - DOI - PubMed

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