Acinetobacter baumannii has been characterized by CDC, WHO and most National Healthcare Systems worldwide as a critical nosocomial pathogen, and classified as an ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp.) pathogen. Mortality of invasive infections due to A. baumannii exceeds 40%. To highlight its impact on public health, ECDC has organized a special project on national lab co-ordination to accurately detect and report carbapenem-resistant strains, to identify epidemiological factors for infection (or colonization) with carbapenem-resistant A. baumanii at clonal and sub-genomic level. This review aims to describe the history, epidemiology, and evolution of resistance of A. baumannii, and stress the caveats associated with the management of systemic infections. Available active antimicrobials and drugs in the pipeline are listed, and available clinical evidence on their pharmacokinetics and efficacy in various types of infections are described. Clinician’s choice of treatment (drug, and monotherapy vs. combination treatment) depends on the patients’ profile, site of infection and antimicrobial resistance profile. Emphasis is laid on specific patient subpopulations, whose management is discussed.
Tuberculosis remains the world’s top fatal infectious disease, causing more than 1.5 million deaths globally annually, especially in low and/or middle-income countries. Greece, although still considered to be a low prevalence country according to the National and Global Report data, has experienced an epidemiological rise in the post covid era. A major limitation in the identification of the true epidemiological burden is the underreporting, especially of probable cases. The aim of this 4-year retrospective, epidemiological study was to record all newly diagnosed patients with active tuberculosis in a large, tertiary hospital of Northern Greece with their epidemiological and clinical characteristics. The temporal trend of newly diagnosed cases was identified and compared with the reports of the corresponding National Surveillance data. A total of 45 patients were identified with active tuberculosis in the years 2022-2025 with a mean symptom duration of 45 days prior to diagnosis. The patients were mostly adults (≥18 years, 74%), male (66%), of 39 years median age, and 67% natives, of Greek origin. In 38% of the patients the manifestations were exclusively extrapulmonary, more frequently so in the native population. Three strains (6,6%) were rifampicin resistant. This real-world epidemiological study provides a direct reflection of the presentation and prevalence of tuberculosis in the community, describes the clinical spectrum and the available diagnostic approaches, and identifies potential weaknesses of the Health Surveillance system.