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Background    Acinetobacter pittii  is a nosocomial pathogen rarely involved in community-acquired infections. We report for the first time that  A. pittii  can be responsible for cavitary community-acquired pneumonia and study its virulence, and discuss its pathogenesis and treatment options.    Case presentation  A 45-year-old woman with a history of smoking and systemic lupus was admitted to Nimes University Hospital (France) with coughing and sputum lasting for three weeks. Thoracic CT scanner showed cavitary pneumonia. Broncho-alveolar lavage cultures found community-acquired  Acinetobacter calcoaceticus-baumannii  complex. The clinical outcome was favourable after twenty-one days of antimicrobial treatment by piperacillin/tazobactam and amikacin then cefepime. Multilocus sequence typing (MLST) analyses identified an  A. pittii  ST249. Despite the atypical clinical presentation with an unexpected partial destruction of lung parenchyma, we found very low virulence potential of the  A. pittii  strain with nematode killing assays and biofilm formation test. The median time required to kill 50% of the nematodes was 7 ± 0.3 days for  A. pittii  ST249, 7 ± 0.2 days for  A. baumanii  NAB ST2 and 8 ± 0.2 days for  E. coli  OP50, ( p > 0,05 ).  A. pittii  ST249 showed significantly slower biofilm formation than  A. baumanii  NAB ST2: BFI = 8.83 ± 0.59 vs 3.93 ± 0.27 at 2 h ( p < 0.0001 ), BFI = 6.3 ± 0.17 vs 1.87 ± 0.12 at 3 h ( p < 0.0001 ) and BFI = 3.67 ± 0.41 vs 1.7 ± 0.06 after 4 h of incubation ( p < 0.01 ).    Conclusions  Community-acquired  A. pittii  should be considered as possible cause of sub-acute cavitary pneumonia particularly in a smoking and/or immunocompromised patient despite its low virulence potential.

First report of cavitary pneumonia due to community-acquired Acinetobacter pittii, study of virulence and overview of pathogenesis and treatment