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Acinetobacter baumannii Outbreaks of the Acinetobacter bacteria are mainly found in intensive care units and areas with highly ill people, rarely occurring outside of healthcare settings. The bacteria pose little threat to healthy people, but patients with weakened immune systems and other comorbidities are more susceptible to transmission. The bacteria can cause blood infec- tions, pneumonia, meningitis, urinary tract infections and wound in- fections, and are often resistant to commonly prescribed antibiotics. The bacteria gained the nickname "Iraqibacter" after exhibiting an extremely high presence in war-zone medical facilities in Iraq and Af- ghanistan and causing infections in wounded soldiers. Bacteroides fragilis B. fragilis is a normal bacteria found in the intestinal tract and the co- lon. However, it can cause infections, most commonly in cohort with other bacteria. While inherently resistant to penicillins, most antibacte- rial regimens can eliminate the infection. However, the bacteria's slow growth, increasing antimicrobial resistance and co-occurrence with other pathogens can make treatment more complicated. Burkholderia cepacia B. cepacia is a group of gram-negative bacteria. They generally prefer aquatic environments, often found colonized in intravenous solu- tions and irrigation systems in healthcare settings. The bacteria pose the highest threat to patients with chronic lung diseases, such as cystic fibrosis, and can lead to pneumonia due to suppressed lung health. B. cepacia are resistant to a number of antibiotics and can be spread via contaminated medications and medical devices, human to human con- tact or touching a contaminated surface. Clostridium difficile One of the most well-known HAIs, C. diff causes inflammation of the colon, and symptoms can range from diarrhea to life-threatening colitis. Antibiotic-associated diarrhea is the most common symptom, following medication ingestion that eliminates good bacteria from the intestine along with the bad. The bacteria are transmitted via the fecal- oral route, most commonly being transferred from an infection site to another patient by a healthcare provider's hands. C. diff is resistant to many routine cleaning products, including alcohol-based hand clean- ers, so it is able to survive in clinical locations for extended periods of time. C. diff can usually be treated with antibiotics, but in some cases a stool transplant may help restore bacterial imbalances. Clostridium sordellii C. sordellii is a rare bacteria, most often causing infections in patients with underlying medical conditions. The bacteria can cause pneumo- nia, endocarditis, peritonitis and myonecrosis, and severe cases can lead to sepsis, though rarely. C. sordellii mainly affects women and is often linked to end of pregnancy, whether the pregnancy resulted in childbirth, abortion or spontaneous abortion. Its transmission route is still unknown. Carbapenem-resistant Enterobacteriaceae The Enterobacteriaceae bacteria family is infamous for its resistance to antibiotics, mainly carbapenem antibiotics, the class of antibiotics often used as a final line of defense against infections. Enterobacteriaceae are normally found in the gut but can cause serious infections if they travel to other parts of the body. CRE can be transmitted via human to human contact or coming in contact with an infected device, such as a catheter. The bacteria have the ability to innately break down carbapenems, ren- dering that class of antibiotic useless in infection control. CRE infections can have up to a 50 percent mortality rate. Enterococcus faecalis Another highly antibiotic-resistant bacteria, E. faecalis' resistance is inherent. The bacteria contain penicillin-binding proteins and are able to bypass folate synthesis, an important step in bacteria elimi- nation. Recently, Enterococcus bacteria have acquired resistance to vancomycin, leaving just a few treatment options for patients. While the bacteria are normally found in the gut, they can cause infection when they spread, notably causing urinary tract infections, sepsis and wound infections. E. faecalis is a resilient bacteria, with the abil- ity to survive in a temperature range of 50 degrees to 115 degrees Fahrenheit. Escherichia coli E. coli is another bacteria group commonly found in the gut but can also become pathogenic. It is the leading cause of urinary tract infec- tions in hospitals, but can also cause gastroenteritis, pneumonia or even neonatal meningitis. The O157:H7 strain is commonly found as the source of infection in patients. Serious E. coli infections may lead to hemolytic-uremic syndrome, a disease that destroys red blood cells, causes acute kidney failure and reduces platelet counts. The E. coli bac- teria have inhabited the earth for an estimated 20 million to 30 million years. E. coli is a very diverse bacteria — only 20 percent of its genome is found in all strains — and some researchers suggest it should be taxo- nomically reclassified. Hepatitis A The Hepatitis A virus is the least common of the three major Hepa- titis viruses found in healthcare settings. The virus is spread through the fecal-oral route, and healthcare personnel are often infected when handling a patient in whom the infection is not yet recognized, is fecal incontinent or has diarrhea. The HAV vaccine is strongly rec- ommended for children in the U.S. between their first and second birthdays, and it has proven to be extremely effective in community- acquired HAV infections. Hepatitis B Hepatitis B can cause acute infections or chronic liver infections. An acute infection typically exhibits liver inflammation, vomiting and jaundice. Some acute cases can turn into chronic Hepatitis B, causing lifelong infection, cirrhosis, liver cancer, liver failure and death. HBV The Centers for disease Control and Prevention estimate one in 20 patients will contract an HAI every day. 21