I asked two similar questions:
Use OLEDB to read AccessFile from Stream to DataSet
Read Microsoft Access File(.accdb) by OpenXML SDK
Under the hood Access Databases rely heavily on file usage. Unlike in-memory database such as SQLLite, Access Db's need a file. Hence you'll have to work with the file using OLEDB, OPENXML or via the Object Model.
Since .Net 4. Streams have a CopyTo method you can use to convert the stream into a temporary accdb file.
string tempFilePath = Environment.GetFolderPath(Environment.SpecialFolder.ApplicationData) + "\\temp.accdb";
using (var fileStream = File.Create(tempFilePath)
{
accDbStream.InputStream.CopyTo(fileStream);
}