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Summary of Key Messages

Acinetobacter bacteria are common inthe environment but are rarely a medicalthreat to healthy, uninjured persons.

Acinetobacter can be acquired byperson-to-person contact, throughcontact with contaminated surfaces, oras a result of wounds contaminated withdirt and debris.

Some types of Acinetobacter areresistant to antibiotics and can besevere and especially difficult to treat ifthey result in bloodstream infections.

Persons most at risk of difficult-to-treatAcinetobacter infections are those whoare very ill, have traumatic wounds, andare treated in intensive care units.

Frequent hand washing and disinfectionof medical treatment facilities are thebest ways to avoid spreading

Acinetobacter.

What isAc inetobacter?

Acinetobacter (a-sin-EE-toe-back-ter) is acommon type of bacteria found in manyplaces in the environment, including water,

soil, and sewage. There are at least 25different types of Acinetobacter.

Acinetobacter baumannii is the particulartype that is often associated with hospital-acquired infections. There is no evidencethat our adversaries are using Acinetobacteras a biological warfare agent.

How do you get Ac inetobacterinfections?

Wounds can be contaminated with dirt anddebris containing Acinetobacter bacteria atthe time of injury. Acinetobacter can alsospread by person-to-person contact andcontact with contaminated surfaces inintensive care units and other healthcaresettings. Other possible sources of infectionare being investigated, and any newInformation on prevention will becommunicated when it becomes available.

Acinetobacte InfectionsInformation for Servicemembers and their Families

A Collaborative Effort of DHSD, AFIOH, DHCC, NEHC, GEIS and USACHPPM

December 8, 2004

What types of infections doesAc inetobactercause?

Infections caused by Acinetobacter in thegeneral population are very rare.

Acinetobacter can cause pneumonia, skinand wound infections, urinary tract infectionblood infections. Bloodstream infectionscaused byAcinetobacter baumannii tend tobe the most severe

What are the symptoms of anAc inetobacter infection?

Symptoms will vary depending on the

specific part of the body that is affected.Symptoms of pneumonia, for instance, couldinclude fever, chills, cough, and shortness ofbreath. A wound infection might causefever and redness, increasing pain, and pusaround the wound. Persons with thesesymptoms should see their health careproviders.

How are Ac inetobacter infectionstreated?

Most types of Acinetobacter are easilytreated with common antibiotics and withother supportive care. Other types of

Acinetobacter, and especially thoseacquired in hospitals, can be resistant tomany commonly prescribed antibiotics andrequire special treatments. Health careproviders identify treatment options for eachinfection on an individual basis.

How many severe Acinetobacterinfections have affected U.S. Servicemenand women?

As of mid-November, 2004, approximately

85 patients who served in Operation IraqiFreedom and Operation Enduring Freedomhave been identified with Acinetobacterbloodstream infections. Our militarytreatment facilities have raised the level ofawareness among their staffs to ensure thatany new infections are promptly identifiedand treated.

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What is being done to preventAc inetobacter infection or to ensure earlytreatment in wounded personnel?

Medical personnel from all branches of themilitary are working together and with theCenters for Disease Control and Prevention(CDC) to identify causes and sources of

Acinetobacterinfection and to prevent futureinfections.

Isolation and infection control proceduressuch as hand washing and wearing ofgowns and gloves by those who havecontact with infected patients are used toprevent transmission to others in ourmedical treatment facilities.

Military medical staffs know that thenumbers of Acinetobacter infections

increase in battlefield situations because ofthe types of traumatic injuries service-members suffer. Because of this, they arepaying increased attention to infectioncontrol procedures and have been told towatch carefully for early signs of infection.

What precautions should hospitalvisitors take againstAc inetobacter?

Visitors should ask the medical staff aboutprecautions before visiting patients.

Visitors coming into contact withAcinetobacter-infected patients should washtheir hands thoroughly before entering andleaving the room to avoid spreading germs.Normal warm or hot water wash cycles on ahome clothes washer should eliminate thesegerms from clothing. Medical staffs willprovide specific instructions if additionalprecautions are necessary.

Should people with weakened immunesystems visit someone with anAc inetobacter infection?

People with weakened immune systemsshould consult their health care provider andthe hospitals infection control staff beforevisiting someone withAcinetobacteror anyother serious infection. Such precautionsapply especially to people with organ

transplants, cancer patients undergoingchemotherapy or radiation therapy, andpeople with acquired immunodeficiencysyndrome (AIDS).

What happens when an Ac inetobacter-infected patient returns home?

Proper hand washing and keeping any openwounds cleaned and dressed may be all thatis required for Acinetobacter patients asprecautions against spreading infectionsupon returning home. Medical staffs will

provide specific instructions if additionalprecautions are necessary.

Where can I get more information?Navy Environmental Health Center (NEHC)Phone: 757-953-0700http://www-nehc.med.navy.milU.S. Army Center for Health Promotion and Preventive Med(USACHPPM)Phone: 1-800-222-9698http://chppm-www.apgea.army.mil

Centers for Disease Control and Preventionhttp://www.cdc.gov/ncidod/hip /ARESIST/acin_general.htmCDC: Morbid ity and Mortality Weekly Report, 2004(November 19, 2004) Volume 53 (No. 45); 1063-1066

Avai lable at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5345a1.h

Air Force Ins ti tute for Operational Healt h (AFIOH)Phone: 1-888-232-ESOH (3764)http://starview.brooks.af.mil/afioh/General medical information: 210-536-1788

DOD Deployment Health Clinical Center (DHCC)Phone: 866-559-1627http://www.pdhealth.mil/

DOD Deployment Health Support Directorate (DHSD)Phone: 800-497-6261http://www.deploymentlink.osd.mil/contact_us/mail_form.shtmlDOD Global Emerging Infection s Surveillance and ResponseSystem (GEIS)Phone: 301-319-9072http://www.geis.fhp.osd.mil

http://www-nehc.med.navy.mil/http://chppm-www.apgea.army.mil/http://www.cdc.gov/ncidod/hip/ARESIST/acin_general.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm5345a1.htmhttp://starview.brooks.af.mil/afioh/http://localhost/var/www/apps/conversion/tmp/scratch_6/http://www.deploymentlink.osd.mil/contact_us/mail_form.shtmlhttp://www.deploymentlink.osd.mil/contact_us/mail_form.shtmlhttp://www.geis.fhp.osd.mil/http://www.geis.fhp.osd.mil/http://www.deploymentlink.osd.mil/contact_us/mail_form.shtmlhttp://www.deploymentlink.osd.mil/contact_us/mail_form.shtmlhttp://localhost/var/www/apps/conversion/tmp/scratch_6/http://starview.brooks.af.mil/afioh/http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5345a1.htmhttp://www.cdc.gov/ncidod/hip/ARESIST/acin_general.htmhttp://chppm-www.apgea.army.mil/http://www-nehc.med.navy.mil/