the a.baumannii reference is directly from the investigative report of the autopsy. There was an additional bacterium, p.luteola (see comments on p.luteola below).
the presence of the two exceedingly rare bacterium IMO was the basis for Perper’s query whether ANS used alcohol swabs prior to injecting. The investigative report also speculates whether it was skin colonized, or a contaminated syringe, and notes that neither the injected substance nor the syringe were made ‘available’ to the autopsy team. the team does not rule out the bacterium being injected. “The possibility that a contaminated product was injected into the tissue cannot be ruled out...” (IMO, if it were ‘skin colonization’ then they could have swabbed any part of her body and gotten a positive result.)
I’ve also questioned why Perper said that KE ‘gave’ ANS neosporin’ and what that huge abscess on KE’s face was, that was not there in her initial interviews. ANS didn’t have a ‘cut’, she had the flu, so why the neosporin, unless, KE knew that ANS had an infected buttock and was trying to treat it with a superficial cream?
the dissertation on a.baumannii is here: (page 10, Investigative Report)
http://www.thesmokinggun.com/archive/years/2007/0326074report10.html
Psuedomonas Luteola:
Pseudomonas luteola is a rare clinical infection, in which no epidemiological trend has been established. Herein described are two patients with P. luteola bacteremia; one with a history of multiple tick bites and a leg ulcer, and the other involved in an all-terrain roll-over crash who developed pneumonia. The rare isolation of P. luteola should be considered significant when isolated in the blood....A screening colonoscopy, which was normal, was performed because P. luteola had been previously shown to be associated with colon cancer. 1 ....P. luteola was first described by Tatum et al (1974). 2 Since then, it has only been involved in 17 reported infections. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15
http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijid/vol4n2/tick.xml
The normal habitat of P. luteola is unclear, although it belongs to a group of bacteria normally found in water, soil, and other damp environments [3,4]. Reported human infections are rare
Reported human P. luteola infections are rare. These have included a septicemia in a patient with systemic lupus erythematosus under corticosteroid therapy who developed haemorrhagic pancreatitis complicated by a pancreatic abscess [5]; one case of bacteremia in a previously healthy patient with granulomatous hepatitis [9]; a bacteremia in a patient with peritonitis [10]; and non-bacteremic cases of peritonitis associated with gangrenous appendititis [10] and continuous ambulatory peritoneal dialysis [11]. Bacteremia has also been reported in patients with indwelling vascular catheters [10-12]. Other clinical isolates have been recovered from the bone of a patient with a femur abscess [10]; from a patient with a subphrenic abscess [10]; from the cerebrospinal fluid and wounds of neurosurgical patients with dural grafts or bone flaps [13]; from an HIV-infected patient with invasive cutaneous infection [3]; and from a patient with facial cellulitis [11]. To the best of our knowledge, only two cases of endocarditis caused by P. luteola have been reported in patients with prosthetic cardiac valves [13,14].
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1274313
Due to the close phylogenetic relatedness between Chryseomonas and Pseudomonas, this bacterium was reassigned to the genus Pseudomonas as Pseudomonas luteola (1). Currently, some authors still call the organism Chryseomonas luteola while others refer to it as Pseudomonas luteola (1, 6, 11, 17).
Previous studies showed that C. luteola may cause septicemia, peritonitis, and endocarditis in patients with health disorders or with indwelling devices (12). Up to now, 14 cases of C. luteola infection have been reported (2, 3, 5, 15, 17). For seven patients the organism was isolated from blood. Infections previously described include primarily septicemia (2), meningitis (10), osteomyelitis, endocarditis (12), and peritonitis (3). Also, its ability to infect critically ill patients who haveundergone surgical operations and/or had indwelling devices has been described (7). In other cases, the infection was associated with other factors, such as immunosuppressive therapy, chronic renal failure, and malignancy (14).
http://jcm.asm.org/cgi/content/full/42/4/1837
P. luteola is uncommonly implicated in clinical infections, but it constitutes a significant nosocomial pathogen causing mainly infections associated with foreign material. This report describes an unusual case of a P. luteola strain that infected and caused cutaneous abscess and bacteraemia in a 65-year-old previously healthy man [Greece; date not given]. He was successfully treated with ceftazidime and amikacin, and was subsequently discharged from the hospital in good health.
http://www.cababstractsplus.org/google/abstract.asp?AcNo=20043140764
Pseudomonas luteola is an aerobic, Gram negative rod, formerly classified as CDC group Ve-1 and Chryseomonas luteola. It is an uncommon clinical isolate. A previously healthy 59-year-old homosexual man with facial cellulitis and Pseudomonas luteola bacteremia is reported. Previously reported cases of P. luteola bacteremia have occurred in association with pancreatic abscess, prosthetic valve endocarditis, cardiac surgery, granulomatous hepatitis, peritonitis, and indwelling vascular catheters. This case suggests that the spectrum of disease caused by this bacteria may continue to expand.
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=9934547&dopt=AbstractPlus
The Microbiologist suggests that the bacterium has been known to be contracted in the ocean (via open wound probably such as the one on her buttocks). That is a outside possibility, but at the very least, a good detective pathologist would make note of any report of these bacterium being contracted in bathers in the Bahamas.