Treatment Options for Carbapenem-Resistant and Extensively Drug-Resistant Acinetobacter
              baumannii Infections

Viehman, J. Alexander; Nguyen, M. Hong; Doi, Yohei

doi:10.1007/s40265-014-0267-8

Cited by 199 publications

(183 citation statements)

References 143 publications

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“…The use of ampicillin/sulbactam has been effective for the treatment of systemic infections caused by MDR A. baumannii; however, a steady decline in susceptibility rates has been reported in recent decades (46) (47) . Furthermore, in Latin America, A. baumannii has been commonly reported as being MDR, with high rates of resistance to other antibiotics in addition to carbapenems, including ceftazidime, piperacillin/ tazobactam, and ciprofl oxacin.…”

Section: Discussionmentioning

confidence: 99%

The role of the genetic elements bla oxa and IS Aba 1 in the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in carbapenem resistance in the hospital setting

Kobs¹,

Ferreira

Bobrowicz

et al. 2016

Rev. Soc. Bras. Med. Trop.

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Introduction: Members of the Acinetobacter genus are key pathogens that cause healthcare-associated infections, and they tend to spread and develop new antibiotic resistance mechanisms. Oxacillinases are primarily responsible for resistance to carbapenem antibiotics. Higher rates of carbapenem hydrolysis might be ascribed to insertion sequences, such as the ISAba1 sequence, near bla OXA genes. The present study examined the occurrence of the genetic elements bla OXA and ISAba1 and their relationship with susceptibility to carbapenems in clinical isolates of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex. Methods: Isolates identifi ed over 6 consecutive years in a general hospital in Joinville, Southern Brazil, were evaluated. The investigation of 5 families of genes encoding oxacillinases and the ISAba1 sequence location relative to bla OXA genes was conducted using polymerase chain reaction. Results: All isolates presented the bla OXA-51-like gene (n = 78), and 91% tested positive for the bla OXA-23-like gene (n = 71). The presence of ISAba1 was exclusively detected in isolates carrying the bla OXA-23-like gene. All isolates in which ISAba1 was found upstream of the bla OXA-23-like gene (n = 69) showed resistance to carbapenems, whereas the only isolate in which ISAba1 was not located near the bla OXA-23-like gene was susceptible to carbapenems. The ISAba1 sequence position of another bla OXA-23-like -positive isolate was inconclusive. The isolates exclusively carrying the bla OXA-51-like gene (n = 7) showed susceptibility to carbapenems. Conclusions: The presence of the ISAba1 sequence upstream of the bla OXA-23-like gene was strongly associated with carbapenem resistance in isolates of the A. calcoaceticus-A. baumannii complex in the hospital center studied.

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Section: Discussionmentioning

confidence: 99%

The role of the genetic elements bla oxa and IS Aba 1 in the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in carbapenem resistance in the hospital setting

Kobs¹,

Ferreira

Bobrowicz

et al. 2016

Rev. Soc. Bras. Med. Trop.

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show abstract

“…The importance of members of genus Acinetobacter, as pathogens involved in nosocomial infections, is increasing (2). Acinetobacter baumannii is the most prevalent type involved in a broad spectrum of nosocomial infections, such as pneumonia, bacteremia, surgical wound infection, urinary tract infection, and meningitis (3)(4)(5). The longterm survival potential of this organism in hospital environment as well as its capability of acquiring drug resistance genes has increased their role in nosocomial infections (6).…”

Section: Introductionmentioning

confidence: 99%

Molecular Analysis of the Isolates of Acinetobacter baumannii isolated from Tehran Hospitals Using ERIC-PCR Method

et al. 2018

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Background and Objective:Acinetobacter is a genus of non-fermenting Gram-negative cocci or coccobacilli, which have low nutritional requirements for growth and can survive for a long time in adverse conditions, on dry surfaces, and also in aqueous environments. The importance of the members of Acinetobacter genus as pathogens involved in nosocomial infections, is increasing. Acinetobacter baumannii is the most common species involved in a broad spectrum of nosocomial infections, including pneumonia, bacteremia, surgical wound infections, urinary tract infections, and meningitis. In this study, enterobacterial repetitive intergenic consensus sequence-based PCR (ERIC-PCR) technique was used for analysis and molecular typing of Acinetobacter strains, which has high discrimination power compared to phenotypic markers. Methods:In the present study, a total of 40 A. baumanniies strains were isolated from patients hospitalized in Tehran hospitals. After identification and confirmation of the isolates by serotyping and biochemical tests, a single colony of each isolate was cultured on liquid LB medium, and after DNA extraction, PCR was performed. After electrophoresis of PCR product, gel images were stored electronically for analysis and comparison of the isolates. Results:In this study, 40 strains of A. baumannii were analyzed by ERIC-PCR method, of which 29 strains were typed into 10 groups and 11 other strains had no PCR bands or had a band that could not be assigned to any of the above groups. Conclusion:In this study, it was found that A. baumanniie strains could be typed using repetitive sequences. This extent of polymorphism shows that ERIC-PCR is a useful method for analysis of genetic variation of A. baumannii strains. High genetic variation of A. baumannii strains may be due to wide geographical distribution of this species in Iran

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“…Mortality rates for carbapenem-resistant A. baumannii infections may be as high as 76% (3). Treatment options for carbapenem-resistant A. baumannii infections have not been well defined but generally include polymyxins (colistin and polymyxin B), tigecycline, or sulbactam, alone or in combination with a second agent, such as rifampin or a carbapenem, with the expectation of synergistic activities (4). However, toxicity (polymyxins), suboptimal pharmacokinetics (tigecycline), and the propensity for development of resistance (sulbactam) limit these options (1).…”

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confidence: 99%

Comparison of Minocycline Susceptibility Testing Methods for Carbapenem-Resistant Acinetobacter baumannii

et al. 2016

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cTreatment options for infections due to carbapenem-resistant Acinetobacter baumannii are extremely limited. Minocycline is a semisynthetic tetracycline derivative with activity against this pathogen. This study compared susceptibility testing methods that are used in clinical microbiology laboratories (Etest, disk diffusion, and Sensititre broth microdilution methods) for testing of minocycline, tigecycline, and doxycycline against 107 carbapenem-resistant A. baumannii clinical isolates. Susceptibility rates determined with the standard broth microdilution method using cation-adjusted Mueller-Hinton (MH) broth were 77.6% for minocycline and 29% for doxycycline, and 92.5% of isolates had tigecycline MICs of <2 g/ml. Using MH agar from BD and Oxoid, susceptibility rates determined with the Etest method were 67.3% and 52.3% for minocycline, 21.5% and 18.7% for doxycycline, and 71% and 29.9% for tigecycline, respectively. With the disk diffusion method using MH agar from BD and Oxoid, susceptibility rates were 82.2% and 72.9% for minocycline and 34.6% and 34.6% for doxycycline, respectively, and rates of MICs of <2 g/ml were 46.7% and 23.4% for tigecycline. In comparison with the standard broth microdilution results, very major rates were low (ϳ2.8%) for all three drugs across the methods, but major error rates were higher (ϳ5.6%), especially with the Etest method. For minocycline, minor error rates ranged from 14% to 37.4%. For tigecycline, minor error rates ranged from 6.5% to 69.2%. The majority of minor errors were due to susceptible results being reported as intermediate. A cinetobacter baumannii has become a major health care-associated pathogen over the past 2 decades, due to its intrinsic resistance to several classes of antimicrobial agents, its propensity to acquire resistance to other drug classes, and its ability to resist desiccation in environments typically found in hospitals (1). A. baumannii causes a variety of infections, with respiratory tract infections being the most common (1). Significant clinical challenges are posed by carbapenem-resistant A. baumannii, which accounted for over 75% of A. baumannii clinical isolates tested in a recent global survey (2). Mortality rates for carbapenem-resistant A. baumannii infections may be as high as 76% (3). Treatment options for carbapenem-resistant A. baumannii infections have not been well defined but generally include polymyxins (colistin and polymyxin B), tigecycline, or sulbactam, alone or in combination with a second agent, such as rifampin or a carbapenem, with the expectation of synergistic activities (4). However, toxicity (polymyxins), suboptimal pharmacokinetics (tigecycline), and the propensity for development of resistance (sulbactam) limit these options (1).Minocycline is a semisynthetic tetracycline derivative that was introduced into clinical practice in the 1960s (5). With the recent reintroduction of an intravenous formulation of minocycline, there is increasing interest in this agent as an additional treatment option for carbapenem-resi...

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Treatment Options for Carbapenem-Resistant and Extensively Drug-Resistant Acinetobacter baumannii Infections

Cited by 199 publications

References 143 publications

The role of the genetic elements bla oxa and IS Aba 1 in the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in carbapenem resistance in the hospital setting

The role of the genetic elements bla oxa and IS Aba 1 in the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in carbapenem resistance in the hospital setting

Molecular Analysis of the Isolates of Acinetobacter baumannii isolated from Tehran Hospitals Using ERIC-PCR Method

Comparison of Minocycline Susceptibility Testing Methods for Carbapenem-Resistant Acinetobacter baumannii

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