Evaluation of Gram-Negative Bacilli Isolated from Patients in Intensive Care Units

Naldan, Muhammet Emin; Coşkun, Mehmet Veysel; Ünal, Onur; Karaşahin, Ömer; Vural, Mete Koray

doi:10.4274/tybd.15238

Cited by 2 publications

(2 citation statements)

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“…Acinetobacter sp . strains are one of the most common pathogens in ICUs in our country[6]. The dissemination of resistance to carbapenems and recent resistance to colistin are major problems for our country and the world.…”

Section: Discussionmentioning

confidence: 99%

“…strains were resistant to colistin[4]. Per the limited reported data, colistin resistance in ABC strains is rare in our country[5,6], with most of our isolates resistant to carbapenems but susceptible to colistin[7,8]. Knowledge of the risk factors is important for colistin resistance, since colistin appears to be the only remaining therapeutic option for patients with pneumonia due to XDR ABC.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors and clinical responses of pneumonia patients with colistin-resistantAcinetobacter baumannii-calcoaceticus

Aydemir

Tuz

Pişkin

et al. 2019

WJCC

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BACKGROUND Nosocomial infections with carbapenem-resistant Acinetobacter baumannii-calcoaceticus complex (ABC) strains are great problem for intensive care units. ABC strains can develop resistance to all the antibiotics available. Carbapenem resistance is common and colistin resistance is rare in our country. Knowing the risk factors for colistin resistance is important since colistin seems to be the only remaining therapeutic option for the patients with pneumonia due to extensively drug resistant ABC for our country. AIM To investigate the comparison of clinical responses and outcomes between pneumonia patients with colistin-susceptible and -resistant Acinetobacter sp . Strains. METHODS During the study period, 108 patients with pneumonia due to colistin-susceptible strains and 16 patients with colistin-resistant strains were included retrospectively. Continuous variables were compared with the Mann-Whitney U test, and categorical variables were compared using Pearson’s chi-square test or Fisher’s Exact chi-square test for two groups. A binary logistic regression model was developed to identify the potential independent factors associated with colistin resistance in patients with colistin-resistant strains. RESULTS High Acute Physiology and Chronic Health Evaluation II scores (OR = 1.9, 95%CI: 1.4-2.7; P < 0.001) and prior receipt of teicoplanin (OR = 8.1, 95%CI: 1.0-63.3; P = 0.045) were found to be independent risk factors for infection with colistin-resistant Acinetobacter sp . Different combinations of antibiotics including colistin, meropenem, ampicillin/sulbactam, amikacin and trimethoprim/sulfamethoxazole were used for the treatment of patients with colistin-resistant strains. Although the median duration of microbiological cure ( P < 0.001) was longer in the colistin-resistant group, clinical ( P = 0.703), laboratory ( P = 0.277), radiological ( P = 0.551), microbiological response ( P = 1.000) and infection related mortality rates ( P = 0.603) did not differ between the two groups. Among the patients with infections due to colistin-resistant strains, seven were treated with antibiotic combinations that included sulbactam. Clinical (6/7) and microbiological (5/7) response rates were quite high in these patients. CONCLUSION The optimal therapy regimen is unclear for colistin-resistant Acinetobacter sp . infections. Although combinations with sulbactam seems to be more effective in our study patients, data supporting the usefulness of combinations with sulbactam is very limited.

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Section: Discussionmentioning

confidence: 99%