Treatment Options for &lt;em&gt;K. pneumoniae&lt;/em&gt;, &lt;em&gt;P. aeruginosa&lt;/em&gt; and &lt;em&gt;A. baumannii&lt;/em&gt; Co-resistant to Carbapenems, Aminoglycosides, Colistin and Tigecycline. An Approach Based on the Mechanisms of Resistance to Carbapenems

Karakonstantis, Stamatis; Kritsotakis, Evangelos I.; Gikas, Achilleas

doi:10.20944/preprints202006.0173.v1

Cited by 4 publications

(1 citation statement)

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“…remained a major issue for medical treatment ( Karakonstantis, 2020 ).Besides, differentiating A. baumannii complex infection from colonization remains difficult and further complicated particularly in polymicrobial infections such as the case in the current study ( Karakonstantis and Kritsotakis, 2021 ). We acknowledge the limitation that the antimicrobial resistance profiles of strain 17-84 to recently approved antibiotics including eravacycline, cefiderocol and rifabutin, which are potential last resort treatment options, were not tested ( Karakonstantis et al., 2020c ; Luna et al., 2020 ). A further study on the treatment of infections caused by such PDR Acinetobacter sp.…”

Section: Resultsmentioning

confidence: 99%

Emergence of ST63 Pandrug-Resistant Acinetobacter pittii Isolated From an AECOPD Patient in China

Yang

Dong

Chen

et al. 2021

Front. Cell. Infect. Microbiol.

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Acinetobacter sp. is among the ESKAPE organisms which represent the major nosocomial pathogens that exhibited a high resistance rate. A. pittii, frequently associated with antimicrobial resistance particularly to carbapenems, is one of the most common Acinetobacter species causing invasive infection. Pandrug resistant A. pittii has rarely been reported. Here, we report the case of a patient with acute exacerbations of chronic obstructive pulmonary disease three years after double lung transplantation and developed severe pneumonia associated with pandrug resistant A. pittii infection. Phenotypic and genomic characteristics of this pandrug resistant isolate (17-84) was identified, and the mechanisms underlying its resistance phenotypes were analyzed. Isolate 17-84 belonged to ST63, carried a non-typable and non-transferable plasmid encoding multiple acquired resistance genes including carbapenemase gene blaOXA-58. Point mutations and acquired resistance genes were identified which were associated with different drug resistance phenotypes. To our knowledge, this is the first detailed phenotypic and genomic characterization of PDR A. pittii causing severe infections in clinical settings. Findings from us and others indicate that A. pittii could serve as a reservoir for carbapenem determinants. The emergence of such a superbug could pose a serious threat to public health. Further surveillance of PDR A. pittii strains and implementation of stricter control measures are needed to prevent this emerging pathogen from further disseminating in hospital settings and the community.

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Section: Resultsmentioning

confidence: 99%

Emergence of ST63 Pandrug-Resistant Acinetobacter pittii Isolated From an AECOPD Patient in China

Yang

Dong

Chen

et al. 2021

Front. Cell. Infect. Microbiol.

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A systematic review of implications, mechanisms, and stability of in vivo emergent resistance to colistin and tigecycline in Acinetobacter baumannii

Karakonstantis

2020

Journal of Chemotherapy

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Difficult to Treat Proteeae strains in high risk Romanian hospital departments

Musuroi

Licker

Rus

et al. 2021

Revista Romana De Medicina De Laborator

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Introduction: Resistance to first-line antibiotics of the Proteeae strains within the difficult-to-treat (DTR) phenotype is a cause of limitation of therapeutic options. The study aimed to characterize these strains, to identify the factors that influence their acquisition and the predictive factors for the patient’s evolution. Material and methods: Between July 2017 and January 2019, 400 of Proteeae strains were isolated from samples of patients admitted to intensive care units (ICUs) and surgical wards of a university hospital in Romania. The identification and testing of antibiotic sensitivity was performed using the Vitek 2 Compact system. The DTR phenotype was defined as the resistance (or intermediate resistance) to all categories of β-lactams, carbapenems and fluoroquinolones. Results: Out of 400 Proteeae strains, 21% were of the DTR type, most of them from the species Providencia stuartii and Proteus mirabilis, identified predominantly on the ICUs. The excess fatality in the DTR subsample compared to the non-DTR subsample was 16.37%. The multivariate analysis identified as independent risk factors: the number of antibiotics administered, the number of days of urinary catheterization, the presence of tracheostomy, nasogastric nutrition, respectively belonging to the species P. stuartii. The probabilities of survival were reduced by the presence of the central venous catheter (CVC), tracheostomy, by the increase of the number of hospitalization days respectively of the number of antibiotics administered. Conclusion: The DTR phenotype in the case of Proteeae strains has been associated especially with the species P. stuartii, with invasive exogenous factors and with an increased fatality.

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Treatment Options for <em>K. pneumoniae</em>, <em>P. aeruginosa</em> and <em>A. baumannii</em> Co-resistant to Carbapenems, Aminoglycosides, Colistin and Tigecycline. An Approach Based on the Mechanisms of Resistance to Carbapenems

Cited by 4 publications

References 131 publications

Emergence of ST63 Pandrug-Resistant Acinetobacter pittii Isolated From an AECOPD Patient in China

Emergence of ST63 Pandrug-Resistant Acinetobacter pittii Isolated From an AECOPD Patient in China

A systematic review of implications, mechanisms, and stability of in vivo emergent resistance to colistin and tigecycline in Acinetobacter baumannii

Difficult to Treat Proteeae strains in high risk Romanian hospital departments

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