Venovenous extracorporeal membrane oxygenation in severe community-acquired Acinetobacter baumannii pneumonia

Introduction: Globally, Acinetobacter baumannii (A. baumannii) is a significant nosocomial pathogen. Community-acquired pneumonia (CAP) caused by A. baumannii is rare, but often associated with severe outcomes. Case presentation: A 48-year-old man was admitted to a local hospital, presenting a 14...

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Main Authors: Lei Jiang, Lin Zhou, Shicong Huang, Zhi Ao, Xiaoli Han
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2025-06-01
Series:Journal of Infection in Developing Countries
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Online Access:https://www.jidc.org/index.php/journal/article/view/19761
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author Lei Jiang
Lin Zhou
Shicong Huang
Zhi Ao
Xiaoli Han
author_facet Lei Jiang
Lin Zhou
Shicong Huang
Zhi Ao
Xiaoli Han
author_sort Lei Jiang
collection DOAJ
description Introduction: Globally, Acinetobacter baumannii (A. baumannii) is a significant nosocomial pathogen. Community-acquired pneumonia (CAP) caused by A. baumannii is rare, but often associated with severe outcomes. Case presentation: A 48-year-old man was admitted to a local hospital, presenting a 14-hour history of acute fever, cough, expectoration, chest pain, and dyspnea. Owing to the development of severe acute respiratory distress syndrome (ARDS) and septic shock, the patient was promptly transferred to our institution for veno-venous extracorporeal membrane oxygenation (VV-ECMO) following intubation and mechanical ventilation. Sputum culture, digital polymerase chain reaction (dPCR) assay of blood, and metagenomic next-generation sequencing (mNGS) assay of bronchoalveolar lavage fluid (BALF) all indicated A. baumannii. The patient responded favorably to treatment with meropenem and tigecycline. The amelioration of his respiratory function allowed for the cessation of ECMO after 7 days; and subsequently, the patient was successfully weaned from ventilatory support. Conclusions: A. baumannii should be considered as a possible causative organism of CAP based on presentation in the tropical or subtropical wet season, a very aggressive clinical course, typical chest imaging features, and the presence of A. baumannii in sputum. ECMO represents an efficacious treatment alternative for severe ARDS and septic shock complications associated with A. baumannii when conventional mechanical ventilation proves inadequate, particularly when initiated early in the clinical course.
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spelling doaj-art-b9278ddb97da4b2595cb4c8ed12998ae2025-08-20T03:14:59ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802025-06-01190610.3855/jidc.19761Venovenous extracorporeal membrane oxygenation in severe community-acquired Acinetobacter baumannii pneumoniaLei Jiang0Lin Zhou1Shicong Huang2Zhi Ao3Xiaoli Han4Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pulmonary and Critical Care Medicine, The People’s Hospital of Zhongxian, Chongqing, ChinaDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China Introduction: Globally, Acinetobacter baumannii (A. baumannii) is a significant nosocomial pathogen. Community-acquired pneumonia (CAP) caused by A. baumannii is rare, but often associated with severe outcomes. Case presentation: A 48-year-old man was admitted to a local hospital, presenting a 14-hour history of acute fever, cough, expectoration, chest pain, and dyspnea. Owing to the development of severe acute respiratory distress syndrome (ARDS) and septic shock, the patient was promptly transferred to our institution for veno-venous extracorporeal membrane oxygenation (VV-ECMO) following intubation and mechanical ventilation. Sputum culture, digital polymerase chain reaction (dPCR) assay of blood, and metagenomic next-generation sequencing (mNGS) assay of bronchoalveolar lavage fluid (BALF) all indicated A. baumannii. The patient responded favorably to treatment with meropenem and tigecycline. The amelioration of his respiratory function allowed for the cessation of ECMO after 7 days; and subsequently, the patient was successfully weaned from ventilatory support. Conclusions: A. baumannii should be considered as a possible causative organism of CAP based on presentation in the tropical or subtropical wet season, a very aggressive clinical course, typical chest imaging features, and the presence of A. baumannii in sputum. ECMO represents an efficacious treatment alternative for severe ARDS and septic shock complications associated with A. baumannii when conventional mechanical ventilation proves inadequate, particularly when initiated early in the clinical course. https://www.jidc.org/index.php/journal/article/view/19761Acinetobacter baumanniipneumoniaseptic shockextracorporeal membrane oxygenation (ECMO)
spellingShingle Lei Jiang
Lin Zhou
Shicong Huang
Zhi Ao
Xiaoli Han
Venovenous extracorporeal membrane oxygenation in severe community-acquired Acinetobacter baumannii pneumonia
Journal of Infection in Developing Countries
Acinetobacter baumannii
pneumonia
septic shock
extracorporeal membrane oxygenation (ECMO)
title Venovenous extracorporeal membrane oxygenation in severe community-acquired Acinetobacter baumannii pneumonia
title_full Venovenous extracorporeal membrane oxygenation in severe community-acquired Acinetobacter baumannii pneumonia
title_fullStr Venovenous extracorporeal membrane oxygenation in severe community-acquired Acinetobacter baumannii pneumonia
title_full_unstemmed Venovenous extracorporeal membrane oxygenation in severe community-acquired Acinetobacter baumannii pneumonia
title_short Venovenous extracorporeal membrane oxygenation in severe community-acquired Acinetobacter baumannii pneumonia
title_sort venovenous extracorporeal membrane oxygenation in severe community acquired acinetobacter baumannii pneumonia
topic Acinetobacter baumannii
pneumonia
septic shock
extracorporeal membrane oxygenation (ECMO)
url https://www.jidc.org/index.php/journal/article/view/19761
work_keys_str_mv AT leijiang venovenousextracorporealmembraneoxygenationinseverecommunityacquiredacinetobacterbaumanniipneumonia
AT linzhou venovenousextracorporealmembraneoxygenationinseverecommunityacquiredacinetobacterbaumanniipneumonia
AT shiconghuang venovenousextracorporealmembraneoxygenationinseverecommunityacquiredacinetobacterbaumanniipneumonia
AT zhiao venovenousextracorporealmembraneoxygenationinseverecommunityacquiredacinetobacterbaumanniipneumonia
AT xiaolihan venovenousextracorporealmembraneoxygenationinseverecommunityacquiredacinetobacterbaumanniipneumonia