Acinetobacter

Question

My daughter (15-years-old) is colonized with Staph. for at least 2 years. Now, 4 months ago, an infection with Acinetobacter baumanii (multiresistant MRGN 3) and lately an infection with Haemophilus influenzae occurred additionally. Her FEV1 value lost 35% in 3 months. Now Acinetobacter is not detectable in the sputum anymore.
Would you in spite of this recommend an i.v. therapy, if yes for which period of time?

Answer

Hello,
we received the following answer from Dr. J. Mainz from Jena:
"We do not know finally, which role Acinetobacter plays for the inflammation in case of CF airways. With this, it is much less deterious, than clear pathogenic germs like P. aeruginosa or Staph. aureus.
Mostly it is tested to be multiresistant.
Haemophilus influenzae is partly colonizing concomitantly, can however also cause clearly problems.
In any case, the necessity of an intensive therapy can be drawn from the clinical worsening with reduction of the FEV1, preferably after gaining another sputum and at the same time searching for other/further causes. In here, other germs and also an ABPA (allergic bronchopulmonary aspergillosis) have to be excluded.
In case an i.v. therapy is initiated in CF, we generally recommend a duration of 14 days due to the germs, that cannot be reached easily because of the biofilm in the viscous secretions of the airways."
Please talk about the necessary procedures with your CF center or the treating physician.

28.01.2016