Carbapenem-resistant Acinetobacter baumannii contamination in an intensive care unit
CONCLUSIONS: We found a strong similarity between the antimicrobial susceptibility profiles of non-clinical and clinical A. baumannii isolates. Such data highlight the ICU environment as a potential origin for the persistence of MDR A. baumannii, and hence the ICU may be a source of hospital-acquired infections caused by this microorganism.
Abstract Since the last 20 years, bacteria of the genus Acinetobacter have been the leading cause of hospital-acquired infections. In addition to the ability of Acinetobacter species to acquire rapid antibiotic resistance, limited knowledge on the mechanisms of multidrug resistance to antibiotics limits the treatment options for such infections. Here, we present a review of cellular processes, including oxidative stress defense, energy metabolism, ppGpp signaling, toxin-antitoxin system, and quorum sensing network in Acinetobacter species and their roles in antimicrobial resistance. Although inhibition of str...
CONCLUSIONS: Most tested Acinetobacter isolates were susceptible to amikacin, underscoring the crucial role of this antibiotic in the treatment of MDR Acinetobacter spp. in our hospital. The emergence of XDR isolates is of serious concern and necessitates close monitoring and surveillance. PMID: 31865943 [PubMed - in process]
ConclusionThese data suggest that a combined 2-h infusion with a higher dosage of meropenem, including a loading dose, may be successful to achieve effective PK parameters.
ConclusionThe multicomponent intervention performed by a multidisciplinary team was effective to eradicate the endemic MDR-Ab.
ConclusionThis study highlights the importance of surveillance of XDR A. baumannii strains, even outside of densely populated cosmopolitan regions, to reveal the epidemiology of pandemic lineages, stressing their threat to public health.
ConclusionAntimicrobial activity of minocycline was dramatically reduced in the presence of serum, which corroborated with our atypical serum protein binding findings. If validated, these results implied dose escalation might not the best approach to improve the clinical efficacy of minocycline for bacteremia. Future investigations will focus on the specificity and mechanism(s) of minocycline protein binding.
ConclusionsImportantly, A. baumannii with colistin heteroresistance phenotype was common. This could be a great concern, since that colistin is often used as a last-resort drug for treatment of A. baumannii infections, highlighting the care is necessary with colistin monotherapy. In addition, more effective strategy and surveillance are required to confine and prevent the inter- and/or intra-hospital dissemination of A. baumannii between our therapeutic centers.
AbstractPurpose of ReviewAcinetobacter baumannii (AB) is an infamous nosocomial pathogen with a seemingly limitless capacity for antimicrobial resistance, leading to few treatment options and poor clinical outcomes. The debatably low pathogenicity and virulence of AB are juxtaposed by its exceptionally high rate of infection-related mortality, likely due to delays in time to effective antimicrobial therapy secondary to its predilection for resistance to first-line agents. Recent studies of AB and its infections have led to a burgeoning understanding of this critical microbial threat and provided clinicians with new ammunit...
ConclusionCirculating MDR A. baumannii exhibit genetic heterogeneity with variations in the structure and content of genomic A. baumannii resistance islands and encode multiple putative ARGs. This report represents the first clonal subtype information and genomic characterization of MDR A. baumannii in the country of Georgia and may inform future epidemiological investigations.
Conclusion: Gram-negative organisms, predominantly Acinetobacter, Citrobacter, and Pseudomonas spp, were prevalent on the hands of HCWs who access the cardiac ICU irrespective of the staff category. Antimicrobial resistance was high, with multidrug resistance and carbapenem resistance common among Citrobacter spp and Acinetobacter spp, respectively. Resistance to cefepime and ciprofloxacin was low. PMID: 31687206 [PubMed]