A 6-year surveillance of antimicrobial resistance patterns of
            <i>Acinetobacter baumannii</i>
            bacteremia isolates from a tertiary care hospital in Saudi Arabia during 2005–2010

Gowda, K. Lakshmana; Marie, Mohammed Ali M.; Al‐Sheikh, Yazeed A.; John, James; Gopalkrishnan, Sangeetha; Shashidhar, Pradeep Chikkabidare; Dabwan, Khaled Homoud M

doi:10.3402/ljm.v9.24039

Cited by 15 publications

(8 citation statements)

References 5 publications

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“…Several studies from the central region of Saudi Arabia have reported that the resistance rates of A. baumannii to different antimicrobial classes are increasing over time. A retrospective study conducted at Riyadh Military Hospital during a 6-year period from 2005 to 2010 suggests an increase in multiple resistant patterns among A. baumannii isolates from blood culture isolates [66]. Consistently, another study during a period from 2004 to 2009 at the adult ICU of King Fahad National Guard Hospital have been reported significant decreasing of susceptibility of A. baumannii to divers antimicrobial classes, including imipenem, meropenem, ciprofloxacin, and amikacin [67].…”

Section: Central Areamentioning

confidence: 93%

Prevalence of Acinetobacter baumannii in Saudi Arabia: risk factors, antimicrobial resistance patterns and mechanisms of carbapenem resistance

Ibrahim

2019

Ann Clin Microbiol Antimicrob

113

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Acinetobacter baumannii is an important opportunistic pathogen due to its capabilities for developing mechanisms of resistance to a wide range of antimicrobial agents including carbapenems. This review described the risk factors, antimicrobial susceptibility and mechanisms of carbapenem resistance of A. baumannii from different geographical regions of Saudi Arabia. Several factors including complexity of intensive care unit (ICU) environments, increased numbers of patients with serious diseases, wide spread gastrointestinal colonization and extensive use of antimicrobial drugs led to a wide prevalence of A. baumannii infections in hospitals in Saudi Arabia. A. baumannii has been noted to be less susceptible to antimicrobials agents, including carbapenems, over time, resulting in the evolution of multidrug-resistant (MDR) strains. Dissemination of MDR A. baumannii is attributed to the extreme use of wide-spectrum antimicrobial drugs in hospitals, cross infection between inpatients, invasive ICU procedures, and hospitalized patients with diabetic and cancer those are under frequent invasive diagnostic and therapeutic interventions. Although an increasing prevalence of colistin and tigecycline resistance has been reported in many hospitals, combinations of these agents with carbapenems or other antibiotics remain the best therapeutic choice and reasonably safe to treat patients with MDR A. baumannii infections. The wide distribution of carbapenem resistant A. baumannii (CRAB) due to several mechanisms with diverse genetic determinants has been documented. Although OXA-23 β-lactamase and OXA-51 β-lactamase are the most common genes responsible for CRAB, other novel genes such as blaVIM, PER-1-like and GES-5 have been discovered in carbapenem resistant strains. The high rates of MDR A. baumannii in Saudi hospitals indicate that extensive investigation into the molecular basis of MDR and developing new therapies of CRAB is needed. Moreover, the development of a local antibiogram database coupled with a nationwide antimicrobial stewardship and infection prevention program might help to improve our knowledge of the resistance patterns of A. baumannii, and in developing a treatment protocol for decreasing the infection burden in Saudi Arabia.

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Section: Central Areamentioning

confidence: 93%

Prevalence of Acinetobacter baumannii in Saudi Arabia: risk factors, antimicrobial resistance patterns and mechanisms of carbapenem resistance

Ibrahim

2019

Ann Clin Microbiol Antimicrob

113

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“…With each day passing, there is a rapid increase in bacterial resistance and a chance of ending the drug of choice for treatment [13,27]. Due to the lack of more options and effective antimicrobial agents against multidrug and extremely drug resistant strains, the use of combined drug therapy is increased; in such scenario our findings are even more important.…”

Section: Discussionmentioning

confidence: 93%

“…At present, colistin and tigecycline are being used as drug of choice for the treatment of infection caused by Acinetobacter spp. [12,13]. However, Food and Drug Administration allowed the use of tigecycline only for complicated and soft tissue infections, including intra-abdominal infection and community acquired pneumonia, but did not approve its use for ventilator-associated pneumonia.…”

Section: Introductionmentioning

confidence: 99%

A prospective evaluation of synergistic effect of sulbactam and tazobactam combination with meropenem or colistin against multidrug resistant Acinetobacter baumannii

Marie¹,

Krishnappa

Alzahrani

et al. 2015

Biomol Biomed

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The present study evaluates the synergistic effect of sulbactam/tazobactam in combination with meropenem or colistin against multidrug resistant (MDR) Acinetobacter baumannii isolated from hospitalized patients from a tertiary care hospital in Saudi Arabia. During the study period, 54 multidrug and carbapenem-resistant isolates of A. baumannii isolates were collected from blood and respiratory samples of patients with ventilator-associated pneumonia or bacteremia. Microbroth checkerboard assay (CBA) and E-test were performed to look for synergistic interface of sulbactam and tazobactam with meropenem or colistin. All 54 MDR isolates of A. baumannii were resistant to carbapenem. Minimum inhibitory concentration [50/90] value against sulbactam, tazobactam, meropenem, colistin was found to be 64/128, 64/128, 64/256, and 0.5/1.0 respectively. Synergy was detected in more isolates with CBA compared to E-test. All four combinations showed significant synergistic bactericidal activity. However, the combination with colistin showed greater synergistic effect than combination with meropenem. Antagonism was not detected with any of the combinations and any method, but indifference was seen in tazobactam and colistin combination alone. A significant bactericidal effect was seen with sulbactam combination with meropenem or colistin in both methods. A combination therapy can be a choice of treatment. As colistin is known to exhibit nephrotoxicity, the combination of sulbactam and meropenem might be considered as an alternative antibiotic treatment for such multi- and extremely resistant bacteria. Yet, sample size is small in our study, so further well-designed in vitro and clinical studies on large scale should confirm our findings.

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“…Open reduction and internal fixation is performed for types IIB, IIIA, IIIB, and IV tibial tuberosity avulsion fractures. Several methods of fixation have been reported, but most authors recommend tension band wiring or cannulated screw fixation of the avulsed fragment (Figure 2) [1,3,7].…”

Section: Discussionmentioning

confidence: 99%

Tibial Tuberosity Fracture (Type III-B) in Adolescents: Case Report

Monreal¹

2017

OAJS

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A 6-year surveillance of antimicrobial resistance patterns of Acinetobacter baumannii bacteremia isolates from a tertiary care hospital in Saudi Arabia during 2005–2010

Cited by 15 publications

References 5 publications

Prevalence of Acinetobacter baumannii in Saudi Arabia: risk factors, antimicrobial resistance patterns and mechanisms of carbapenem resistance

Prevalence of Acinetobacter baumannii in Saudi Arabia: risk factors, antimicrobial resistance patterns and mechanisms of carbapenem resistance

A prospective evaluation of synergistic effect of sulbactam and tazobactam combination with meropenem or colistin against multidrug resistant Acinetobacter baumannii

Tibial Tuberosity Fracture (Type III-B) in Adolescents: Case Report

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