Acinetobacter species as nosocomial pathogens
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In summary,Acinetobacter colonization or infection may originate from the patients' own flora under the pressure of antimicrobial selection, the hands of staff members, or contaminated equipment. Transmission ofAcinetobacter strains between patients occurs primarily via the hands of health care workers. In outbreak situations, colonized or infected patients and the inanimate environment, which can be secondarily contaminated, are the main reservoirs in the hospital setting for crosstransmission. However, colonized or infected patients seem to be the most important source of cross-contamination, as epidemic strains spread easily throughout different wards. Especially in prolonged outbreaks in which control efforts such as proper hand washing, glove changing, and restriction of antimicrobial agents are ineffective and specific sources such as contaminated equipment are not identified, the source of the epidemic strain is likely the patients' inanimate dry environment [45, 48].
In outbreak situations it is necessary that isolatedAcinetobacter strains are identified to the genomic species level and then typed before epidemiological conclusions can be drawn, becauseAcinetobacter spp. are ubiquitous organisms [3, 31].
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