Outcome of ventilator-associated pneumonia due to multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa treated with aerosolized colistin in neonates: a retrospective chart review

Evaluation of Ventilator-Associated Tracheitis in Children with Pre-Existing Tracheostomies: Organisms and Empiric Coverage Objectives: This study aims to describe the outcomes, microbiome, and empiric antimicrobial coverage of ventilator associated tracheitis (VAT) in pediatric patients with pre-existing tracheostomies. Patients and Methods: This is a retrospective chart review of pediatric patients with pre-existing tracheostomies admitted to the Children’s Hospital of Georgia for initial inpatient treatment for VAT between January 1, 2007 and February 21, 2021. Patients were evaluated for incidence of ventilator associated pneumonia (VAP), tracheostomy culture results, and antibiotic choice. Results: Thirty-nine patients were included. Across all patients evaluated with pre-existing tracheostomies, 60% developed VAT. There was no difference in the development in VAP between shorter and longer treatment durations (0 vs 1, p = 1). Patients who developed Pseudomonas aeruginosa VAT were likely to have a previous culture of P. aeruginosa (p = 0.003), have a tracheostomy for longer (p = 0.011), and be older than 1 year of age (p = 0.0002). MRSA VAT was associated with a previous culture growing MRSA (p= 0.0042). Conclusions: VAT incidence was higher than what was shown in pediatric patients without pre-existing tracheostomies but VAP incidence was lower and there was no difference between treatment groups. VAT should be treated based on previous cultures and Pseudomonas aeruginosa should be considered as a causative organism.

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Prevalence of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa in an Italian hospital

Journal of Infection and Public Health ◽

10.1016/j.jiph.2012.11.006 ◽

2013 ◽

Vol 6 (3) ◽

pp. 179-185 ◽

Cited By ~ 13

Author(s):

M.A. De Francesco ◽

G. Ravizzola ◽

L. Peroni ◽

C. Bonfanti ◽

N. Manca

Keyword(s):

Pseudomonas Aeruginosa ◽

Acinetobacter Baumannii ◽

Multidrug Resistant ◽

Italian Hospital

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Evaluation of Moringa Peregrina (Forsk) Fiori, Leaf and Seed Extract Against Multidrug Resistant Strains of Bacteria and Fungus of Clinical Origin

Archives of Ecotoxicology ◽

10.36547/ae.2021.3.1.20-26 ◽

2021 ◽

Vol 3 (1) ◽

pp. 20-26

Author(s):

Suliman Mansour Albalawi ◽

Abdulrahman K. Al-Asmari ◽

Syed Rafatullah ◽

Maysa Mahfoud

Keyword(s):

Pseudomonas Aeruginosa ◽

Growth Inhibition ◽

Acinetobacter Baumannii ◽

Bacterial Resistance ◽

Antimicrobial Agents ◽

Colorimetric Assay ◽

Multidrug Resistant ◽

Klebsiella Pneumonia ◽

Isolation And Purification ◽

Moringa Peregrina

The emergence of antibiotic resistant microorganism strains has become a critical concern in the treatment of infectious diseases and makes the search of an alternative therapy a must. The study was designed to evaluate the in vitro antimicrobial activities of the Moringa peregrina (MP) leave (MPL) and seed (MPS) extracts. Antimicrobial assays were performed using a microplate growth inhibition assay against 11 multidrug-resistant (MDR) strains. Following qualitative analysis, dose-response assays were performed using the MTT colorimetric assay. The results showed a strong correlation between the MPL and MPS extract concentration and growth inhibition (P<0.001). MP extract revealed a remarkable antimicrobial effect and inhibited the growth and survival of MDR pathogens which include Escherichia coli; Pseudomonas aeruginosa; Klebsiella pneumonia; Acinetobacter baumannii; Staphylococcus aureus between (88.6-94.7 %) and between (62.3- 88.7%) against Candida Kefyer; Candida parapsilosis; Candida albicans; Candida glabrata; Aspergillus flavus and Fusarium oxysporum. MIC50 ranging from ≤6.25 to 25 mg/mL. Acinetobacter baumannii and Pseudomonas aeruginosa were the most susceptible to MP extracts (MIC50 < 6.25 mg/mL). These results support the use of MP in Arab traditional medicine as natural antimicrobial agents. Additionally, the use of such naturally occurring adjuvant derived from medicinal plants can be used as an adjuvant with synthetic antibiotics to combat bacterial resistance and to enhance the antibacterial potential. Further studies are recommended on isolation and purification of novel antimicrobial molecules to treat the infections caused by microbes.

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Incidence and predictors of 14-day mortality in multidrug-resistant Acinetobacter baumannii in ventilator-associated pneumonia

The Journal of Infection in Developing Countries ◽

10.3855/jidc.6812 ◽

2015 ◽

Vol 9 (12) ◽

pp. 1323-1330 ◽

Cited By ~ 7

Author(s):

Basima Abdalla Almomani ◽

Amanda McCullough ◽

Rawan Gharaibeh ◽

Shaher Samrah ◽

Fatimah Mahasneh

Keyword(s):

Critical Care ◽

Acinetobacter Baumannii ◽

Case Series ◽

Positive Culture ◽

Multidrug Resistant ◽

Ventilator Associated Pneumonia ◽

Retrospective Case ◽

Critical Care Units ◽

Susceptibility Data ◽

Case Series Study

Introduction: Ventilator-associated pneumonia (VAP) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) is common in hospitals and impacts patient survival. We determined the incidence of MDR-AB VAP in critical care units and examined the predictors of 14-day mortality in these patients. Methodology: A retrospective case series study was conducted at a tertiary referral teaching hospital in north Jordan. A list of patients with a positive culture of A. baumannii between January 2007 and June 2013 was retrieved using computerized hospital databases. Medical records of all these patients were reviewed, and cases of VAP infected with MDR-AB were identified. Predictors of 14-day mortality were determined using multivariable logistic regression adjusted for possible confounders. Results: Out of 121 A. baumannii-VAP cases, 119 (98.3%) were caused by MDR-AB. The incidence rate of MDR-AB VAP was 1.59 cases per 100 critical care unit admissions. The mortality of A. baumannii-VAP cases in critical care units was 42% (50/119). Being prescribed two or more definitive antibiotics (prescribed based on susceptibility data) (OR = 0.075, 95% CI = 0.017–0.340, p = 0.001) and ipratropium/salbutamol during mechanical ventilation (OR = 0.140, 95% CI = 0.028–0.705, p = 0.017) were independently associated with lower hospital mortality. Conclusions: Our results suggest incidence of MDR-AB VAP in critical care units is high and that prescription of antibiotics based on antibiotic susceptibility and use of bronchodilators is associated with lower mortality in this population. Larger prospective studies are needed to explore whether these findings can be replicated in different clinical settings.

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In VitroActivity of RX-P873 against Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.04840-14 ◽

2015 ◽

Vol 59 (4) ◽

pp. 2280-2285 ◽

Cited By ~ 5

Author(s):

Robert K. Flamm ◽

Paul R. Rhomberg ◽

Ronald N. Jones ◽

David J. Farrell

Keyword(s):

Pseudomonas Aeruginosa ◽

Acinetobacter Baumannii ◽

Active Agent ◽

Multidrug Resistant ◽

Surveillance Program ◽

Gram Negative ◽

Content Type ◽

Highly Active ◽

Bacterial Ribosome

ABSTRACTRX-P873 is a novel antibiotic from the pyrrolocytosine series which exhibits high binding affinity for the bacterial ribosome and broad-spectrum antibiotic properties. The pyrrolocytosines have shownin vitroactivity against multidrug-resistant Gram-negative and Gram-positive strains of bacteria known to cause complicated urinary tract, skin, and lung infections, as well as sepsis.Enterobacteriaceae(657),Pseudomonas aeruginosa(200), andAcinetobacter baumannii(202) isolates from North America and Europe collected in 2012 as part of a worldwide surveillance program were testedin vitroby broth microdilution using Clinical and Laboratory Standards Institute (CLSI) methodology. RX-P873 (MIC90, 0.5 μg/ml) was >32-fold more active than ceftazidime and inhibited 97.1% and 99.5% ofEnterobacteriaceaeisolates at MIC values of ≤1 and ≤4 μg/ml, respectively. There were only three isolates with an MIC value of >4 μg/ml (all were indole-positiveProtea). RX-P873 (MIC50/90, 2/4 μg/ml) was highly active againstPseudomonas aeruginosaisolates, including isolates which were nonsusceptible to ceftazidime or meropenem. RX-P873 was 2-fold less active againstP. aeruginosathan tobramycin (MIC90, 2 μg/ml; 91.0% susceptible) and colistin (MIC90, 2 μg/ml; 99.5% susceptible) and 2-fold more potent than amikacin (MIC90, 8 μg/ml; 93.5% susceptible) and meropenem (MIC90, 8 μg/ml; 76.0% susceptible). RX-P873, the most active agent againstAcinetobacter baumannii(MIC90, 1 μg/ml), was 2-fold more active than colistin (MIC90, 2 μg/ml; 97.0% susceptible) and 4-fold more active than tigecycline (MIC90, 4 μg/ml). This novel agent merits further exploration of its potential against multidrug-resistant Gram-negative bacteria.

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