Clinical importance and cost of bacteremia caused by nosocomial multi drug resistant acinetobacter baumannii

Gülen, Tuğba Arslan; Güner, Rahmet; Çelikbilek, Nevreste; Keske, Şiran; Taşyaran, Mehmet A.

doi:10.1016/j.ijid.2015.06.014

Cited by 75 publications

(84 citation statements)

References 25 publications

(22 reference statements)

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“…In intensive care unit (ICU) patients, the digestive tract is an important epidemiological reservoir for MDRAB infections in hospital outbreaks (6). MDRAB is disseminated worldwide (6,7) and is highly resistant to a number of available antibiotics, including aminoglycosides, quinolones, penicillin, cephalosporin, and carbapenems. At present, colistin and tigecycline have been employed as alternative therapeutic options for MDRAB infections.…”

Section: Introductionmentioning

confidence: 99%

In vitro assessment of cefoperazone-sulbactam based combination therapy for multidrug-resistant Acinetobacter baumannii isolates in China

Li¹,

Sheng²,

Gu³

et al. 2018

J. Thorac. Dis.

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Background: Multidrug-resistant Acinetobacter baumannii (MDRAB) has emerged as an important pathogen of nosocomial infections. Even though cefoperazone-sulbactam is frequently used to treat MDRAB infections, this single-drug therapeutic approach often results in antibiotic resistance. Thus, combination therapy is preferred over single-drug therapy, particularly in the case of carbapenemase-producing gram negative bacteria. The aim of this study was to investigate the efficacy of cefoperazone-sulbactam combined with either tigecycline or rifampicin against clinical isolates of MDRAB. Methods: One hundred and three MDRAB bacteria were isolated from patients in two hospitals in China.The Epsilomer test (E test) was used to determine the minimum inhibitory concentration (MIC) values for amikacin, ceftazidime, cefepime, levofloxacin, rifampicin, cefoperazone-sulbactam, meropenem, tigecycline, and gentamicin against MDRAB isolates. In vitro effects of various antibiotic combinations were measured and the fractional inhibitory concentration index (FICI) was calculated for each drug combination.Results: Approximately 17.5% of the isolates were resistant to tigecycline, whereas more than 84.2%isolates were resistant to other antimicrobial agents tested in this study. Cefoperazone-sulbactam revealed remarkable synergistic effects when used in combination with either tigecycline or rifampicin. However, for the isolates with MICs lower than blood peak concentration after combination therapy, the ratio was lower in highly resistant isolates compared to the least resistant bacteria. Conclusions: In vitro cefoperazone-sulbactam in combination with tigecycline or rifampicin showed the highest synergistic or additive activity against MDRAB isolates. However, acquisition of highly antibiotic resistant bacteria may lessen the effectiveness of combination therapy.

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Section: Introductionmentioning

confidence: 99%

In vitro assessment of cefoperazone-sulbactam based combination therapy for multidrug-resistant Acinetobacter baumannii isolates in China

Li¹,

Sheng²,

Gu³

et al. 2018

J. Thorac. Dis.

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“…Multidrug-resistance to antibiotics currently available, in particular in Gram-negative bacteria, has created a critical global medical challenge (2). Acinetobacter baumannii is frequently observed as a nosocomial infection, which causes high mortality, morbidity and hospitalization cost (3). Crude mortality rate and attributable mortality of the infection were reported to be 52 and 10-35%, respectively (4).…”

Section: Introductionmentioning

confidence: 99%

Active efflux pump adeB is involved in multidrug resistance of Acinetobacter baumannii induced by antibacterial agents

Zhang

Wang

Xie

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to investigate the resistance of Acinetobacter baumannii, which was induced by cefepime (FEP), cefoperazone-sulbactam (SCF), tazobactam (TZP), levofloxacin (LEV), amikacin (AK), imipenem (IPM), and ciprofloxacin (CIP), in vitro. Multi-step drug resistance selection of 16 A. baumannii strains was performed using seven antibacterial agents (FEP, TZP, CIP, AK, IPM, SCF, and LEV). The minimum inhibitory concentration (MIC) was determined using the agar dilution method. Random amplified polymorphic DNA polymerase chain reaction was performed to analyze the genotypes and the carrying rates of aac (3) (8-to 128-fold) were noted in the MIC and different genotypes were showed in RAPD of the strains before and after performing the drug resistant test. PCR data revealed significant differences (P<0.05) between the carrying rates of resistant genes before and after drug induction, with the exception of rmtA, OXA-24, TEM-1, and IMP. Significant increases were demonstrated in the comparative adeB grayscale in strains that underwent drug induction when compared with the sensitive strains (55.69±43.11% vs. 10.08±26.35%; P=0.001). Findings of the present study suggest that the active efflux pump, adeB, has an important role in multidrug resistance of the A. baumannii induced by antibacterial agents in vitro. IntroductionAlthough carbapenems antibiotics remain the backbone therapy for severe suspected bacterial infections, resistance to this antimicrobial treatment has been increasingly reported (1). Thus, therapeutic options have become limited. Multidrug-resistance to antibiotics currently available, in particular in Gram-negative bacteria, has created a critical global medical challenge (2). Acinetobacter baumannii is frequently observed as a nosocomial infection, which causes high mortality, morbidity and hospitalization cost (3). Crude mortality rate and attributable mortality of the infection were reported to be 52 and 10-35%, respectively (4). Multidrug-resistant A. baumannii is considered as a leading cause of nosocomial infection, particularly in critically ill patients (5). A. baumannii has been reported to be resistant to a broad range of antimicrobial agents, and the tendency for its epidemic spread has subsequently extended (6). An increasing drug resistance of A. baumannii to carbapenems has been demonstrated by the SENTRY Antimicrobial Surveillance Program, whose objective was to report antimicrobial susceptibility and pathogen occurrence data for >40,000 episodes of BSI in 72 medical centers representing 22 nations since January 1997 (7). The emergence of multidrug and pandrug-resistant A. baumannii has caused major threats to the infection control and treatment plans in clinical practices (8). According to our knowledge, drug resistance of A. baumannii is closely related with the application of antibacterial agents. However, few studies have been performed to investigate whether a single antibacterial agent was able to induce pandrug resistance of A. baumannii. In the...

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“…As Infecções Relacionadadas à Assistência à Saúde (IRAS) constituem um grave problema de saúde pública global, com alto impacto nas taxas de morbidade, mortalidade, tempo de internação e custos associados aos cuidados ao paciente (Gulen et al, 2015;Maragakis e Perl, 2008). Esse prolongamento do tempo de permanência e dos cuidados a saúde prestados oneram não somente as instituições de saúde, mas a sociedade como um todo.…”

Section: Infecções Relacionadas à Assistência à Saúdeunclassified

“…baumannii (ACB) (Gulen et al, 2015). Os micro-organismos pertencentes a este gênero apresentam a morfologia de bacilos durante a fase de crescimento exponencial e de cocobacilos na fase estacionária, agrupados aos pares.…”

Section: Acinetobacter Sppunclassified

“…Os micro-organismos pertencentes a este gênero apresentam a morfologia de bacilos durante a fase de crescimento exponencial e de cocobacilos na fase estacionária, agrupados aos pares. São Gram-negativos, encapsulados, aeróbios estritos, indol-negativos, não-fermentadores de glicose, catalase-positivos, oxidase-negativos e imóveis (Perez et al, 2007 (Cosgaya et al, 2016, Gulen et al, 2015, Nemec et al, 2015.…”

Section: Acinetobacter Sppunclassified

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Caracterização genética e perfil de sensibilidade antimicrobiana de cepas multirresistentes de Acinetobacter baumannii presentes em um hospital de ensino

Tavares¹

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, que são meu refúgio, minha fonte de energia e personificações do amor em meio às atribulações. AGRADECIMENTOSA Deus e ao plano espiritual, acima de tudo e por tudo.Aos meus avós Ioni e Mário, por todo o suporte, carinho e pela compreensão durante todos esses anos. Sem vocês por perto eu não teria chegado até aqui! Aos meus pais Rosa Maria e Paulo, por sempre terem me provido do necessário e de ainda muito mais a fim de que eu conquistasse todos os objetivos da minha vida e realizasse cada sonho meu. Pelo amor, apoio e carinho incondicionais. Por terem acreditado, assim como eu, que eu poderia chegar até aqui. Não há nada na minha vida que não seja graças a vocês.À minha irmã Ísis por todo o amor, toda a amizade e cumplicidade. Você é a certeza e o conforto de que jamais estarei só nessa grande viagem.A toda a minha família, por ser tão presente e prestativa. Cada telefonema, cada visita, conversa e convite alegram meus dias.Às minhas amigas Ana Paula Cassiolato, Juliana Failde, Juliana Pinhata, Natália Fernandes, Nathamy Fernanda e, especialmente, Gabriela Francisco e Maria Fernanda Bueno por todo auxílio profissional, pessoal e pela nossa amizade que transcende a pós-graduação.Aos amigos Viviane Santana, Cristiane Pinho, Muriel Cestari e Eugênio Telles por todo o apoio e compreensão sempre.Às amigas Fracotes Ana Maria Ruocco, Fernanda Helena Palermo, Juliana Stahl Pinto, Marília Quinalha e Suyen Safuan Naide, irmãs que a vida me deu. É maravilhoso poder acompanhar a evolução e os desdobramentos do caminho de cada uma. Vocês são parte de quem eu sou hoje.Aos amigos Gabriela Fonseca, Letícia Oliveira e Marcelo Corral por terem me recebido tão calorosamente no programa de pós-graduação, dandome a oportunidade de participar ativamente do programa e, principalmente, por toda a ajuda e amizade.Aos companheiros Sérgio Bokermann, Vanda Eliana Garcia Brandolim, Izilda Penha Rodrigues Zuba, Djalma Zuba e todo o Grupo de Amigos, por terem me devolvido tantas vezes ao eixo e me ensinado a ter calma e paciência -ou, ao menos, tentado.Ao meu orientador Carlos Henrique Camargo, pela oportunidade concedida, pelos ensinamentos transmitidos e pela grande inspiração. Por ter acreditado no meu potencial e me dado espaço para crescer, me desenvolver e me descobrir. . ursingii, A. variabilis, A. gyllenbergii (n=1, 0.9% each) and Acinetobacter spp (n=2; 1.7%). A. baumannii isolates were submitted to multiplex PCR for other oxacillinases and ISAba1 detection, antimicrobial susceptibility testing, molecular typing by pulsed field gel electrophoresis (PFGE), trilocus sequence typing (3LST) and multilocus sequence typing (MLST). blaOXA-23-like gene was detected in 105 isolates (92.1%), of which 100% were associated with ISAba1; blaOXA-72 was present in one isolate (0.9%) and blaOXA-231, in two isolates (1.7%). The majority (n=66; 57.9%) of isolates were classified as extensively resistant (XDR). The PFGE grouped the isolates into 11 clusters (A-K) and MLST identified the isolates belonging mainly to CC79 (42.4%), CC1 (16.6%), CC15 (...

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Clinical importance and cost of bacteremia caused by nosocomial multi drug resistant acinetobacter baumannii

Cited by 75 publications

References 25 publications

In vitro assessment of cefoperazone-sulbactam based combination therapy for multidrug-resistant Acinetobacter baumannii isolates in China

In vitro assessment of cefoperazone-sulbactam based combination therapy for multidrug-resistant Acinetobacter baumannii isolates in China

Active efflux pump adeB is involved in multidrug resistance of Acinetobacter baumannii induced by antibacterial agents

Caracterização genética e perfil de sensibilidade antimicrobiana de cepas multirresistentes de Acinetobacter baumannii presentes em um hospital de ensino

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