Editing Acinetobacter (section)

==Clinical significance==
<!--Intro concerning all Acinetobacter-->
''Acinetobacter'' is frequently isolated in [[nosocomial infection]]s, and is especially prevalent in [[intensive care unit]]s, where both sporadic cases and [[epidemic]] and [[Endemic (epidemiology)|endemic]] occurrences are common. ''A. baumannii'' is a frequent cause of [[Pneumonia#Hospital-acquired|hospital-acquired pneumonia]], especially of late-onset, [[ventilator-associated pneumonia]]. It can cause various other infections, including skin and wound infections, [[bacteremia]], and [[meningitis]], but ''A. lwoffi'' is mostly responsible for the latter.{{citation needed|date=August 2022}}

<!-- A. baumannii disease -->
Of the ''Acinetobacter'', ''A. baumannii'' is the greatest cause of human disease, having been implicated in a number of hospital-acquired infections such as bacteremia, urinary tract infections (UTIs), secondary meningitis, infective endocarditis, and wound and burn infections.<ref>{{cite journal | last1 = Dent Lemuel | first1 = L | last2 = Marshall | first2 = DR | last3 = Pratap | first3 = S | last4 = Hulette | first4 = RB | year = 2010 | title = Multidrug resistant Acinetobacter baumannii: a descriptive study in a city hospital | journal = BMC Infect Dis | volume = 10 | page = 196 | doi=10.1186/1471-2334-10-196| pmid = 20609238 | pmc = 2909240 | doi-access = free }}</ref> In particular, ''A. baumannii'' is frequently isolated as the cause of hospital-acquired pneumonia among patients admitted to the [[intensive care unit]]. Risk factors include long-term intubation and tracheal or lung aspiration. In most cases of ventilator-associated pneumonia, the equipment used for artificial ventilation such as endotracheal tubes or bronchoscopes serve as the source of infection and result in the colonization of the lower respiratory tract by ''A. baumannii''. In some cases, the bacteria can go on to enter the bloodstream, resulting in bacteremia with mortality rates ranging from 32% to 52%. UTIs caused by ''A. baumannii'' appear to be associated with continuous catheterization, as well as antibiotic therapy. ''A. baumannii'' has also been reported to infect skin and soft tissue in traumatic injuries and postsurgical wounds. ''A. baumannii'' commonly infect burns and may result in complications owing to difficulty in treatment and eradication. Though less common, some evidence also links this bacterium to meningitis, most often following invasive surgery, and, in very rare cases, to community-acquired primary meningitis wherein the majority of the victims were children.<ref>{{cite journal | last1 = Siegman-Igra | first1 = Y | last2 = Bar-Yosef | first2 = S | last3 = Gorea | first3 = A | last4 = Avram | first4 = J | year = 1993 | title = Nosocomial Acinetobacter meningitis secondary to invasive procedures: report of 25 cases and review | journal = Clin Infect Dis | volume = 17 | issue = 5| pages = 843–849 | doi=10.1093/clinids/17.5.843| pmid = 8286623 }}</ref> Case reports also link ''A. baumannii'' to endocarditis, keratitis, peritonitis, and very rarely fatal neonatal sepsis.<ref>{{cite journal | last1 = Falagas | first1 = ME | last2 = Karveli | first2 = EA | last3 = Kelesidis | first3 = I | last4 = Kelesidis | first4 = T | year = 2007 | title = Community acquired Acinetobacter infections | journal = Eur J Clin Microbiol Infect Dis | volume = 26 | issue = 12| pages = 857–868 | doi=10.1007/s10096-007-0365-6| pmid = 17701432 | s2cid = 25898468 }}</ref>

<!-- A. baumannii resistance/resilience -->
The clinical significance of ''A. baumannii'' is partially due to its capacity to develop resistance against many available antibiotics. Reports indicate that it possesses resistance against broad-spectrum [[cephalosporin]]s, [[β-lactam antibiotic]]s, [[aminoglycosides]], and [[Quinolone antibiotic|quinolones]]. Resistance to [[carbapenem]]s is also being increasingly reported.<ref>{{cite journal | last1 = Hu | first1 = Q | last2 = Hu | first2 = Z | last3 = Li | first3 = J | last4 = Tian | first4 = B | last5 = Xu | first5 = H | last6 = Li | first6 = J | year = 2011 | title = Detection of OXA-type carbapenemases and integrons among carbapenem-resistant Acinetobactor baumannii in a Teaching Hospital in China | journal = J Basic Microbiol | volume = 51 | issue = 5| pages = 467–472 | doi=10.1002/jobm.201000402| pmid = 21656808 | s2cid = 10955468 | doi-access = free }}</ref><ref>{{cite journal | first1 = Pierre Edouard | last1 = Fournier | last2 = Richet | first2 = H | year = 2006 | title = The epidemiology and control of Acinetobacter baumannii in healthcare facilities | doi =10.1086/500202 | pmid = 16447117 | journal = Clin Infect Dis | volume = 42 | issue = 5| pages = 692–699 | doi-access = free }}</ref> ''A. baumannii'' can survive on the human skin or dry surfaces for weeks and is resistant to a variety of disinfectants, making it particularly easy to spread in a hospital setting.<ref name=Peleg2008>{{cite journal|title=''Acinetobacter baumannii'': Emergence of a Successful Pathogen |author1=Peleg AY |author2=Seifert H |author3=Paterson DL |journal=Clinical Microbiology Reviews |date=July 2008 |volume=21 |issue=3 |pages=538–582 |pmc=2493088 |doi=10.1128/CMR.00058-07 |pmid=18625687}}</ref> Antibiotic resistance genes are often plasmid-borne, and plasmids present in ''Acinetobacter'' strains can be transferred to other pathogenic bacteria by [[horizontal gene transfer]].{{citation needed|date=December 2022}}

<!-- Role in Allergy -->
In healthy individuals, ''Acinetobacter'' colonies on the skin correlate with low incidence of [[allergies]];<ref>{{Cite journal | last1 = Hanski | first1 = I. | last2 = Von Hertzen | first2 = L. | last3 = Fyhrquist | first3 = N. | last4 = Koskinen | first4 = K. | last5 = Torppa | first5 = K. | last6 = Laatikainen | first6 = T. | last7 = Karisola | first7 = P. | last8 = Auvinen | first8 = P. | last9 = Paulin | first9 = L. | last10 = Makela | first10 = M. J. | last11 = Vartiainen | first11 = E. | last12 = Kosunen | first12 = T. U. | last13 = Alenius | first13 = H. | last14 = Haahtela | first14 = T. | title = Environmental biodiversity, human microbiota, and allergy are interrelated | doi = 10.1073/pnas.1205624109 | journal = Proceedings of the National Academy of Sciences | volume = 109 | issue = 21 | pages = 8334–8339 | year = 2012 | pmid =  22566627| pmc = 3361383| bibcode = 2012PNAS..109.8334H | doi-access = free }}</ref> ''Acinetobacter'' is thought to be allergy-protective.<ref>{{Cite journal
| last1 = Debarry | first1 = J.
| last2 = Hanuszkiewicz | first2 = A.
| last3 = Stein | first3 = K.
| last4 = Holst | first4 = O.
| last5 = Heine | first5 = H.
| title = The allergy-protective properties of Acinetobacter lwoffii F78 are imparted by its lipopolysaccharide
| doi = 10.1111/j.1398-9995.2009.02253.x
| journal = Allergy
| volume = 65
| issue = 6
| pages = 690–697
| year = 2009
| pmid = 19909295
| s2cid = 28194712
}}</ref>