Factors Associated with Multidrug-Resistant Acinetobacter Transmission: An Integrative Review of the Literature

Multidrug-resistant (MDR) Acinetobacter infections are occurring at alarming rates in traumatic war injuries. Causative factors have not been specifically identified. We used an integrative review of the literature guided by the Identifying, Organizing, and Synthesizing strategy to identify factors related to MDR Acinetobacter transmission. We identified five major themes of commonality relating to transmission-wound types, risk factors, contributing factors, modes of transmission, and prevention strategies-and we identified studies that should be replicated in military populations. We identified sources of transmission (ie, environment to wound, health care worker to wound) and interventions to reduce or eliminate health care-associated or surgical site MDR Acinetobacter infections (ie, using strict infection control guidelines, appropriate use of antibiotics, notification of infected patients).