Rapid emergence of colistin resistance and its impact on fatality among healthcare-associated infections

Aydın, Mehtap; Ergönül, Önder; Azap, Alpay; Bilgin, Hüseyin; Çavuş, Sema Alp; Demıroğlu, Yusuf Zıya; Alışkan, Hikmet Eda; Memikoğlu, Osman; Menekşe, Şirin; Kaya, Şafak; Demir, Nazlım Aktuğ; Karaoğlan, İlkay; Başaran, Seniha; Hatipoğlu, Çiğdem Ataman; Erdinç, Şebnem; Yılmaz, Emel; Tümtürk, Ayhanım; Tezer, Yasemin; Demirkaya, Hasan Can; Çakar, Şule Eren; Keske, Şiran; Tekin, Süda; Yardımcı, Cem; Karakoç, Çağla; Ergen, Pınar; Azap, Özlem Kurt; Mülazımoğlu, Lütfiye; Ural, Onur; Can, Füsun; Akalın, Halis

doi:10.1016/j.jhin.2017.11.014

Cited by 47 publications

(33 citation statements)

References 7 publications

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“…A. baumannii is the most common nosocomial pathogen that causes bloodstream infections (BSI) or ventilator-associated pneumonia (VAP) in many medical centers, particularly in Turkey (2, 5). Carbapenem resistance rates exceed 90% in some parts of the World (3).…”

Section: Discussionmentioning

confidence: 99%

In Vitro Activity of Eravacycline in Combination with Colistin Against Carbapenem-Resistant A. baumannii Isolates

Özger

Çuhadar

Yıldız

et al. 2019

Preprint

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26The synergistic activity of eravacycline in combination with colistin on carbapenem-resistant 27 A.baumannii (CRAB) isolates was evaluated in this study. Minimum inhibitory 28 concentrations (MICs) of eravacycline and colistin were determined by the broth 29 microdilution method. MICs values ranged between 1 to 4 mg and 0,5 to 128 mg/L for 30 eravacycline and colistin, respectively. In-vitro synergy between eravacycline and colistin 31 was evaluated by using the chequerboard methodology. Synergistic activity was found in 10 32 % of the strains, and additive effect in 20 %. No antagonism was detected. Similar activity 33 was also observed in colistin resistant CRAB isolates. The result of this study indicates that 34 eravacycline and colistin combination may be a potential therapeutic option for the treatment 35 of CRAB related infections. (CRAB) is an important nosocomial 53 pathogen causing substantial morbidity and mortality (1, 2). Current treatment options 54 (polymyxins, tigecycline, aminoglycosides) for CRAB are limited and suffer from 55 pharmacokinetic limitations such as high toxicity and low plasma levels (3). Therefore, to 56 enhance clinical efficacy and to avoid toxicity, combination therapy is often used for CRAB 57 infections (4). 58Eravacycline is a novel fluorocycline that belongs to the tetracycline class of 59 antimicrobials may be a treatment option for CRAB (5). In vitro studies were shown that 60 eravacycline minimum inhibitory concentrations (MICs) were found to be 2-8 fold lower 61 than tigecycline MICs against CRAB (6-8). The drug is also active against colistin resistant 62 strains (9). Despite in vitro activity, treatment success of eravacycline in CRAB infections are 63 unknown due to lack of clinical trials (10, 11). Management of healthcare-associated 64 infections (HCAI) caused by CRAB should be required combination therapy. There is no in 65 vitro study related to the synergism of eravacycline with other antibiotics in the literature. 66The aim of this in vitro study is to evaluate the synergistic activity of eravacycline in 67 combination with colistin on CRAB isolates. 68 Results 69Ten carbapenem-resistant A. baumannii strains were used in this study. Three of these 70 strains were also resistant to colistin. All isolates were found to have bla OXA-51 and nine 71 harbored bla OXA-23. The characteristics of 10 CRAB isolates included in chequerboard 72 experiments were shown in Table 1. 73MIC values ranged between 1 to 4 mg and 0,5 to 128 mg/L for eravacycline and 74 colistin, respectively. Chequerboard analysis showed 10% synergy, 20% additive, 70% 132This research received no specific grant from any funding agency in the public, commercial, 133 or not-for-profit sectors.

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Section: Discussionmentioning

confidence: 99%

In Vitro Activity of Eravacycline in Combination with Colistin Against Carbapenem-Resistant A. baumannii Isolates

Özger

Çuhadar

Yıldız

et al. 2019

Preprint

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“…Colistin use has been limited by emergence of resistance among KPC-Kp, with reported rates up to 40% especially in areas burdened by high CR prevalence [84,85]. The recent discovery of plasmid-mediated colistin resistance has also important implications for the spread of these highly resistant strains [86].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Antimicrobial treatment challenges in the era of carbapenem resistance

Peri

Doi

Potoski

et al. 2019

Diagnostic Microbiology and Infectious Disease

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“…1) [3]. Carbapenem resistance exceeded 90% in Acinetobacter baumannii and approached 50% among Klebsiella pneumoniae isolates [3,4]. Although colistin resistance data were not collected by the WHO-CAESAR, research indicates that it may reach 76% among carbapenem-resistant enterobacteria in Turkey [5].…”

Section: Antimicrobial Stewardship Programmes In Turkeymentioning

confidence: 99%

Antibiotic overconsumption and resistance in Turkey

Isler

Keske

Aksoy

et al. 2019

Clinical Microbiology and Infection

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The latest report of the OECD Health Policy Studies stated that in 2015 the highest rates of antimicrobial resistance (around 35% in Turkey, Korea and Greece) were seven times higher than the lowest rates among its member countries. As the OECD country with the highest rate of resistance (38.8%), despite a 15-year hospital antibiotic restriction programme, Turkey is in urgent need of revising its policies and drawing an effective action plan to reverse the current trend. In this commentary we review previous measures taken to tackle antimicrobial overuse and resistance in Turkey and discuss their effectiveness.

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Rapid emergence of colistin resistance and its impact on fatality among healthcare-associated infections

Cited by 47 publications

References 7 publications

In Vitro Activity of Eravacycline in Combination with Colistin Against Carbapenem-Resistant A. baumannii Isolates

In Vitro Activity of Eravacycline in Combination with Colistin Against Carbapenem-Resistant A. baumannii Isolates

Antimicrobial treatment challenges in the era of carbapenem resistance

Antibiotic overconsumption and resistance in Turkey

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