Large increase in bloodstream infections with carbapenem-resistant Acinetobacter species during the first 2 years of the COVID-19 pandemic, EU/EEA, 2020 and 2021

Kinross, Pete; Gagliotti, Carlo; Merk, Hanna; Plachouras, Diamantis; Monnet, Dominique; Högberg, Liselotte Diaz

doi:10.2807/1560-7917.es.2022.27.46.2200845

Cited by 26 publications

(25 citation statements)

References 19 publications

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“…Recent data from the European Antimicrobial Resistance Surveillance Network (EARS-Net) show a large and statistically significant increase of Acinetobacter spp. BSIs in the European Union (EU) and European Economic Area (EEA) during 2020–2021 (+ 57% compared to 2018-2019), a period which represents the first years of the COVID-19 pandemic [ 4 ]. In a systemic review of pan-drug-resistant (PDR) Gram-negative bacteria epidemiology and prognosis, Pseudomonas aeruginosa and A. baumannii were the most common PDR reported species (33%), followed by Klebsiella pneumoniae (24%) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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In vitro activities of omadacycline, eravacycline, cefiderocol, apramycin, and comparator antibiotics against Acinetobacter baumannii causing bloodstream infections in Greece, 2020–2021: a multicenter study

Galani

Papoutsaki

Karaiskos

et al. 2023

Eur J Clin Microbiol Infect Dis

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Resistance of Acinetobacter baumannii to multiple clinically important antimicrobials has increased to very high rates in Greece, rendering most of them obsolete. The aim of this study was to determine the molecular epidemiology and susceptibilities of A. baumannii isolates collected from different hospitals across Greece. Single-patient A. baumannii strains isolated from blood cultures (n = 271), from 19 hospitals, in a 6-month period (November 2020–April 2021) were subjected to minimum inhibitory concentration determination and molecular testing for carbapenemase, 16S rRNA methyltransferase and mcr gene detection and epidemiological evaluation. 98.9% of all isolates produced carbapenemase OXA-23. The vast majority (91.8%) of OXA-23 producers harbored the armA and were assigned mainly (94.3%) to sequence group G1, corresponding to IC II. Apramycin (EBL-1003) was the most active agent inhibiting 100% of the isolates at ≤16 mg/L, followed by cefiderocol which was active against at least 86% of them. Minocycline, colistin and ampicillin-sulbactam exhibited only sparse activity (S <19%), while eravacycline was 8- and 2-fold more active than minocycline and tigecycline respectively, by comparison of their MIC50/90 values. OXA-23-ArmA producing A. baumannii of international clone II appears to be the prevailing epidemiological type of this organism in Greece. Cefiderocol could provide a useful alternative for difficult to treat Gram-negative infections, while apramycin (EBL-1003), the structurally unique aminoglycoside currently in clinical development, may represent a highly promising agent against multi-drug resistant A. baumanni infections, due to its high susceptibility rates and low toxicity.

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Section: Introductionmentioning

confidence: 99%

“…in 2018–2019, experienced the most noticeable increases (+116%) in Acinetobacter spp. BSIs in 2020–2021 compared with 2018–2019 and suggested surveillance at local, national and EU/EEA levels to monitor whether this worrying development is halted or even reversed [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

In vitro activities of omadacycline, eravacycline, cefiderocol, apramycin, and comparator antibiotics against Acinetobacter baumannii causing bloodstream infections in Greece, 2020–2021: a multicenter study

Galani

Papoutsaki

Karaiskos

et al. 2023

Eur J Clin Microbiol Infect Dis

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“…The COVID-19 pandemic led to significant changes in AMR trends for invasive isolates [ 7 , 8 ]. A recent study by the ECDC revealed a large increase in CRAb in the European Union and European Economic Area during the first two years of the pandemic [ 14 ]. The latest ECDC EARS-Net data (up to 2022) show that CRAb has increased in blood cultures in Slovenia and all neighboring countries, with the exception of Austria.…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 on Multidrug-Resistant Bacteria at a Slovenian Tertiary Medical Center

Mrvič,

Stevanoska,

Beović

et al. 2024

Antibiotics

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The COVID-19 pandemic has strained healthcare systems globally. Shortages of hospital beds, reassignment of healthcare workers to COVID-19-dedicated wards, an increased workload, and evolving infection prevention and control measures have potentially contributed to the spread of multidrug-resistant bacteria (MDRB). To determine the impact of the COVID-19 pandemic at the University Medical Center Ljubljana, a tertiary teaching hospital, we analyzed the monthly incidence of select bacterial species per patient from 2018 to 2022. The analysis was performed for all isolates and for MDRB isolates. The data were analyzed separately for isolates from all clinical samples, from blood culture only, and from clinical and surveillance samples. Our findings revealed an increased incidence density of patients with Enterococcus faecium, Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa isolates from clinical samples during the COVID-19 period in the studied hospital. Notably, the incidence density of MDRB isolates—vancomycin-resistant E. faecium, extended-spectrum betalactamase-producing K. pneumoniae, and betalactam-resistant P. aeruginosa—from clinical samples increased during the COVID-19 period. There were no statistically significant differences in the incidence density of patients with blood culture MDRB isolates. We observed an increase in the overall MDRB burden (patients with MDRB isolates from both clinical and surveillance samples per 1000 patient days) in the COVID-19 period in the studied hospital for vancomycin-resistant E. faecium, carbapenem-resistant K. pneumoniae, and betalactam-resistant P. aeruginosa and a decrease in the methicillin-resistant S. aureus burden.

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“…BSI in the EU and European Economic Area (EEA) in the first years of the COVID-19 pandemic (2020–21) compared with 2018–19. 4 Additionally, among isolates from ICUs in countries with high (≥50%) prevalence of carbapenem-resistant Acinetobacter spp., carbapenem resistance increased from 73.2% to 85.6% over this 3 year period. 4 …”

Section: Introductionmentioning

confidence: 99%

“… 4 Additionally, among isolates from ICUs in countries with high (≥50%) prevalence of carbapenem-resistant Acinetobacter spp., carbapenem resistance increased from 73.2% to 85.6% over this 3 year period. 4 …”

Section: Introductionmentioning

confidence: 99%

In vitro activity of apramycin (EBL-1003) in combination with colistin, meropenem, minocycline or sulbactam against XDR/PDR Acinetobacter baumannii isolates from Greece

Galani,

Souli,

Katsala

et al. 2024

Journal of Antimicrobial Chemotherapy

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Objectives To evaluate the in vitro activity of the combination of apramycin with colistin, meropenem, minocycline or sulbactam, against some well-characterized XDR Acinetobacter baumannii clinical isolates from Greece, to understand how apramycin can be best incorporated into clinical practice and optimize effectiveness. Methods In vitro interactions of apramycin (0.5×, 1× and 2× the MIC value) with colistin (2 mg/L), meropenem (30 mg/L), minocycline (3.5 mg/L) or sulbactam (24 mg/L) were tested using time–kill methodology. Twenty-one clinical A. baumannii isolates were chosen, exhibiting apramycin MICs of 4–16 mg/L, which were at or below the apramycin preliminary epidemiological cut-off value of 16 mg/L. These isolates were selected for a range of colistin (4–32 mg/L), meropenem (16–256 mg/L), minocycline (8–32 mg/L) and sulbactam (8–32 mg/L) MICs across the resistant range. Synergy was defined as a ≥2 log10 cfu/mL reduction compared with the most active agent. Results The combination of apramycin with colistin, meropenem, minocycline or sulbactam was synergistic, at least at one of the concentrations of apramycin (0.5×, 1× or 2× MIC), against 83.3%, 90.5%, 90.9% or 92.3% of the tested isolates, respectively. Apramycin alone was bactericidal at 24 h against 9.5% and 33.3% of the tested isolates at concentrations equal to 1× and 2× MIC, while the combination of apramycin at 2× MIC with colistin, meropenem or sulbactam was bactericidal against all isolates tested (100%). The apramycin 2× MIC/minocycline combination had bactericidal activity against 90.9% of the tested isolates. Conclusions Apramycin combinations may have potential as a treatment option for XDR/pandrug-resistant (PDR) A. baumannii infections and warrant validation in the clinical setting, when this new aminoglycoside is available for clinical use.

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Large increase in bloodstream infections with carbapenem-resistant Acinetobacter species during the first 2 years of the COVID-19 pandemic, EU/EEA, 2020 and 2021

Cited by 26 publications

References 19 publications

In vitro activities of omadacycline, eravacycline, cefiderocol, apramycin, and comparator antibiotics against Acinetobacter baumannii causing bloodstream infections in Greece, 2020–2021: a multicenter study

In vitro activities of omadacycline, eravacycline, cefiderocol, apramycin, and comparator antibiotics against Acinetobacter baumannii causing bloodstream infections in Greece, 2020–2021: a multicenter study

The Impact of COVID-19 on Multidrug-Resistant Bacteria at a Slovenian Tertiary Medical Center

In vitro activity of apramycin (EBL-1003) in combination with colistin, meropenem, minocycline or sulbactam against XDR/PDR Acinetobacter baumannii isolates from Greece

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