CHAPTER 20

Acinetobacter, Stenotrophomonas, and

Similar Organisms

14th Ed. Section 7 heading:

GN Coccobacilli_MacConkey positive_Oxidase negative

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 Objectives
• List the most common gram-negative organisms discussed in this chapter
that are encountered in clinical specimens.
• Describe where Acinetobacter is found and the patients who are most at
risk of infection.
• Describe the Gram-stain morphologic characteristics of Acinetobacter,
Bordetella, and Stenotrophomonas.
• Describe the appearance and odor of S. maltophilia when grown on blood
agar.
• Differentiate between the two groups of Acinetobacter, and identify the
most dependable test to distinguish them.

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General Characteristics
• Are oxidase negative.
• Grow on MacConkey (MAC) agar (except the Centers for Disease
Control and Prevention [CDC] group NO-1).
• Do not ferment glucose.
• Oxidize (saccharolytic) or do not use glucose (asaccharolytic).
• Commonly encountered genera are:
• Acinetobacter
• Stenotrophomonas

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 Acinetobacter and Stenotrophomonas
• Are the second and third most commonly encountered gram-negative
rods.
• Are widely distributed in nature, including hospitals.

• May become skin and respiratory flora of hospitalized patients.

• Flora of hospitalized patients may become colonized when medical
devices (e.g., catheters) are introduced into sterile sites.

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Morphologic Characteristics
• Acinetobacter
• Plump Gam negative coccobacilli
• Smooth, opaque, raised, and creamy colonies on blood agar
• Non-lactose fermenter (NLF) with purplish hue on MAC agar
• Bordetella
• Coccobacilli or short rods
• Nonlactose fermenter that shows delayed growth on MAC agar
• Stenotrophomonas
• Short to medium–size Gram negative straight rods
• Large, smooth, and glistening colonies with uneven edges and lavender-
green to light purple pigment
• Ammonia smell
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Pathogenic, Gram-Negative, Aerobic Bacilli
• Acinetobacter (A. baumanii)
– NLF, Oxidase negative, Gram negative bacilli
– Grows in soil, water, and sewage
– Opportunistic infections of the respiratory, urinary, and central
nervous systems
– Due to widespread resistance – treatment must be guided by AST

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 Acinetobacter
• Acinetobacter
• Plump coccobacilli; non-motile
• Smooth, opaque, raised, and
creamy colonies on blood agar
• Nonlactose fermenter with
purplish hue on MAC agar
• Catalase positive;
• Aerobic incubation

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 Acinetobacter resistance

OXA-48 (Class D) – Oxacillanases

 Acinetobacter (cont’d)
Saccharolytic Asaccharolytic
• Nonhemolytic • Nonhemolytic
• A. baumanii • A. lwoffi
• A. calcoaceticus
• Hemolytic
• A. anitratus
• None
• A. calcoaceticus subsp.
anitratus
• Hemolytic
• A. alcaligenes
• A. anitratus
• A. haemolyticus
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 Stenotrophomonas maltophilia
• Large GNB
• Rapid maltose oxidizer
• Motile – polar flagella
• Oxidase negative
• Catalase positive
• MacConkey – NLF

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Antimicrobial Susceptibility

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Antimicrobial Susceptibility (cont’d)

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