Colistin hetero-resistance in multidrug-resistant Acinetobacter baumannii clinical isolates from the Western Pacific region in the SENTRY antimicrobial surveillance programme

Yau, W.; Owen, Roxanne J.; Poudyal, Anima; Bell, Jan M.; Turnidge, John; Yu, Heidi H.; Nation, Roger L.; Li, Jian

doi:10.1016/j.jinf.2008.11.002

Cited by 129 publications

(110 citation statements)

References 29 publications

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“…In recent years, there has been an increase in isolation of colistin resistant and heteroresistant ABC strains [3,[15][16][17][18] .…”

Section: Discussionmentioning

confidence: 99%

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Investigation of Colistin Heteroresistance and Some Factors Affecting Heteroresistance in Carbapenem-Resistant A. baumannii Strains

Gazel¹,

Otkun²

2018

mjima

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Introduction: Colistin can be used in patients infected with carbapenem-resistant Acinetobacter baumannii complex (CR-ABC), but recently resistance to colistin and heteroresistance have been reported. In this study we aimed to investigate the colistin heteroresistance rates and the effects of colistin and its combinations on colistin heteroresistance/resistance development in CR-ABC strains in our hospital. Materials and Methods: Heteroresistance analysis was performed on CR-ABC isolates and standard ABC strain [American Type Culture Collection (ATCC) 19606)] strain. To investigate hidden heteroresistance, the isolates were exposed to colistin at sub-inhibitory concentrations. 'Time-kill' study was performed on the standard strain and a clinical strain for colistin. Serial passage test was performed to investigate the effects of drug combinations on heteroresistance/resistance development. Results: In the first heteroresistance analysis test, all strains were found to be non-heteroresistant. However, after sub-inhibitory exposure to colistin, colistin heteroresistance/resistance developed in all isolates. In serial passages, colistin-rifampicin and colistin-tigecycline (Col+Tig) combinations were found to be effective and prevented growth of colistin-resistant sub-populations even at sub-inhibitory doses. Colistin-gentamicin (Col+Gen) combination was not found to be effective against the clinical isolate while it was effective on ATCC strain. Colistin-fluconazole combination was found to be ineffective at all concentrations. Conclusion: In our study, it was shown that the strains which were detected to be non-heteroresistant could easily transform to heteroresistant/ resistant forms after exposure to colistin. Colistin-rifampicin and Col+Tig combinations were found to be effective and prevented the emergence of heteroresistance/resistance to colistin even at low concentrations. At low concentrations, Col+Gen combination was ineffective against the clinical ABC isolate. Colistin-fluconazole combination failed to inhibit the emergence of resistant bacteria. Heteroresistance or resistance to colistin may easily develop because of inappropriate use of this antibiotic. To prevent this condition, colistin should be administrated at appropriate doses and in combination with the suggested antibiotics. Keywords: Colistin, carbapenem, combination, heteroresistance, rifampin Giriş: Kolistin, karbapenem dirençli Acinetobacter baumannii kompleks (CR-ABC) enfeksiyonu olan hastalarda kullanılabilecek seçeneklerdendir, ancak son zamanlarda kolistin için de direnç ve heterodirenç bildirilmiştir. Bu çalışmada hastanemizde izole edilen CR-ABC suşlarında, kolistin heterojen direnç oranını ve kolistinin ve bu ilacın ikili kombinasyonlarının kolistin heterodirenç/direnç gelişimi üzerine etkilerini araştırmayı amaçladık. Gereç ve Yöntem: Karbapenem dirençli A. baumannii izolatları vve standart ABC suşu [American Type Culture Collection (ATCC) 19606] üzerinde heterojen direnç analizi yapıldı. Gizli heterodirenç/direnci ortaya çıkarabil...

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“…In recent years, there has been an increase in isolation of colistin resistant and heteroresistant ABC strains [3,[15][16][17][18] .…”

Section: Discussionmentioning

confidence: 99%

“…Colistin heteroresistance has been defined as an isolate with colistin minimum inhibitory concentrations (MIC) <=2 mg/L, in which detectable subpopulations were able to grow in the presence of >2 mg/L colistin [1,3] . This heteroresistance is thought to be induced by exposure to colistin [1,4] .…”

Section: Introductionmentioning

confidence: 99%

Investigation of Colistin Heteroresistance and Some Factors Affecting Heteroresistance in Carbapenem-Resistant A. baumannii Strains

Gazel¹,

Otkun²

2018

mjima

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“…Several investigators have reported heteroresistance to colistin in A. baumannii, which has been supposed to cause the emergence of colistin resistance by exposure to colistin [68][69][70]. Heteroresistance is generally defined as a case in which subpopulations of antibiotic-susceptible bacteria show resistance to certain antibiotics [71].…”

Section: Colistin Dependencementioning

confidence: 99%

Old drug, new findings: colistin resistance and dependence of Acinetobacter baumannii

Choi

Lee

2017

Precis Future Med

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Colistin is an old drug, and its use has recently resurged because of increasing antibiotic resistance in gram-negative bacteria such as Acinetobacter baumannii. Although the colistin resistance rates in gram-negative bacteria are currently not high, many colistin-resistant isolates are being identified and the possibility of horizontal transmission of colistin resistance has increased because of the plasmid-borne colistin resistance gene mcr-1 (mobilized colistin resistance). In this review, we have discussed colistin resistance in A. baumannii. In addition, we have reviewed an abnormal phenomenon called colistin dependence in A. baumannii.

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“…Heteroresistance to colistin was initially described among clinical A. baumannii (Li et al, 2006;C.H. Tan et al, 2007;Yau et al, 2009) and Enterobacter cloacae isolates (Lo-Ten-Foe et al, 2007). Intrestingly, in A. baumannii, this heteroresistance was documented to be related to previous colistin therapy (Hawley et al, 2008).…”

Section: Heteroresistance Among Gram Negative Nosocomial Pathogensmentioning

confidence: 99%

Heteroresistance

Meletis¹

2012

Infection Control - Updates

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Colistin hetero-resistance in multidrug-resistant Acinetobacter baumannii clinical isolates from the Western Pacific region in the SENTRY antimicrobial surveillance programme

Cited by 129 publications

References 29 publications

Investigation of Colistin Heteroresistance and Some Factors Affecting Heteroresistance in Carbapenem-Resistant A. baumannii Strains

Investigation of Colistin Heteroresistance and Some Factors Affecting Heteroresistance in Carbapenem-Resistant A. baumannii Strains

Old drug, new findings: colistin resistance and dependence of Acinetobacter baumannii

Heteroresistance

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