scholarly journals Prevalence of Tigecycline resistance in Multidrug-Resistant Acinetobacter species isolates from clinical specimens

2019 ◽  
Vol 7 (2) ◽  
pp. 42-47
Author(s):  
Moni Mahto ◽  
Banodita Acharya Dhungel
Keyword(s):  
Acinetobacter Baumannii ◽  
Antibiotic Susceptibility ◽  
Therapeutic Option ◽  
Treatment Options ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Acinetobacter Baumanii ◽  
Acinetobacter Species ◽  
Institutional Review ◽  
Almost All

Background and Objectives: Acinetobacter baumanii is ubiquitous, aerobic non fermentative, gram negative cocobacilli, emerging globally as an important cause of nosocomial infection. This study was conducted to determine the prevalence and antibiogram of clinically isolated multidrug-resistant Acinetobacter species. Material and methods: Antibiotic susceptibility of 93 Acinetobacter baumannii isolates were performed against ampicillin, ampicillin/sulbactam, piperacillin/tazobactam, ceftazidime, cefepime, ceftriaxone, cefotaxime, ciprofloxacin, levofloxacin, amikacin, gentamicin, imipenem, meropenem, tigecycline, polymyxin B and colistin as per standard methods in microbiology laboratory of Nepal Mediciti Hospital, Kathmandu, Nepal from January to December 2018. Ethical clearance was taken from the Institutional review committee of Nepal Mediciti Hospital. Results: A total of 93 Acinetobacter baumannii isolates were obtained from sputum, blood, pus, wound swabs , catheter tips and others. Antibiotic susceptibility analyses of the isolates revealed that the resistance to ampicillin was most common (100%), followed by cefotaxime (75.2%), ceftazidime (74.1%), ampicillin/sulbactam (73.1%), cefepime (67.7%). However, almost all isolates were susceptible to tigecycline (100%), followed by colistin (98.9%), and polymyxin B (87.0%). Conclusion: The present study showed the increasing trends of resistance of Acinetobacter speciesto various classes of antimicrobials. Treatment options for infections due to MDR and XDR Acinetobacter baumanii are very limited and tigecycline and colistin may be considered as one of the therapeutic option for the treatment of hospital acquired infections

scholarly journals Successful Treatment With Intrathecal and Intravenous Polymyxin B-Based Combination Against MDR Acinetobacter baumannii Meningitis in Pediatric Patient: A Case Report

2021 ◽  
Vol 9 ◽  
Author(s):  
Haiyan Xing ◽  
Caiyi Cheng ◽  
Yihua Zhang ◽  
Yongqing Cai ◽  
Xianfeng Wang ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Pediatric Patient ◽  
High Performance ◽  
Therapeutic Option ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Endoscopic Endonasal ◽  
Nosocomial Meningitis ◽  
Pertinent Data ◽  
Life Threatening

Background: Nosocomial meningitis with multidrug-resistant (MDR) or extensively drug-resistant (XDR) Acinetobacter baumannii is a life-threatening complication in neurosurgery. Treatment of these infections is challenging because of poor penetration of the available antibiotics into the cerebrospinal fluid (CSF). Intrathecal (ITH) or intraventricular (IVT) administration of antibiotics is increasingly used as the last treatment option against MDR/XDR Gram-negative bacteria meningitis not responding to intravenous (IV) regimens. However, pertinent data in pediatric patients is scarce.Case Presentation: A 14-year-old male patient developed meningitis from an MDR strain of A. baumannii following endoscopic endonasal resection of craniopharyngioma. Despite a combination therapy involving IV tigecycline, we observed clinical and bacteriologic failure. The patient was then successfully treated with an ITH and IV polymyxin B-based combination. Quantification of tigecycline and polymyxin B in CSF was performed with two-dimensional high-performance liquid chromatography (2D-HPLC) and HDLC coupled with tandem mass spectrometry (HPLC-MS/MS), respectively. Adverse drug reactions (neurotoxicity and skin hyperpigmentation), probably induced by polymyxin B, were acceptable and reversible.Conclusions: The case illustrates ITH and IV Polymyxin B-based combination is an optimal therapeutic option against MDR A. baumannii meningitis in this pediatric patient. In the future, real-time PK/PD data obtained from patients during ITH/IVT polymyxin B therapy should be required to optimize polymyxin use with maximal efficacy and minimal adverse effects.

scholarly journals Radiation-Inactivated Acinetobacter baumannii Vaccine Candidates

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 96
Author(s):  
Stephen J. Dollery ◽  
Daniel V. Zurawski ◽  
Elena K. Gaidamakova ◽  
Vera Y. Matrosova ◽  
John K. Tobin ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Treatment Options ◽  
Bacterial Pathogen ◽  
Multidrug Resistant ◽  
Bacterial Cells ◽  
Wound Infections ◽  
Protein Profiles ◽  
Vaccine Candidates ◽  
Rich Media ◽  
Life Threatening

Acinetobacter baumannii is a bacterial pathogen that is often multidrug-resistant (MDR) and causes a range of life-threatening illnesses, including pneumonia, septicemia, and wound infections. Some antibiotic treatments can reduce mortality if dosed early enough before an infection progresses, but there are few other treatment options when it comes to MDR-infection. Although several prophylactic strategies have been assessed, no vaccine candidates have advanced to clinical trials or have been approved. Herein, we rapidly produced protective whole-cell immunogens from planktonic and biofilm-like cultures of A. baumannii, strain AB5075 grown using a variety of methods. After selecting a panel of five cultures based on distinct protein profiles, replicative activity was extinguished by exposure to 10 kGy gamma radiation in the presence of a Deinococcus antioxidant complex composed of manganous (Mn2+) ions, a decapeptide, and orthophosphate. Mn2+ antioxidants prevent hydroxylation and carbonylation of irradiated proteins, but do not protect nucleic acids, yielding replication-deficient immunogenic A. baumannii vaccine candidates. Mice were immunized and boosted twice with 1.0 × 107 irradiated bacterial cells and then challenged intranasally with AB5075 using two mouse models. Planktonic cultures grown for 16 h in rich media and biofilm cultures grown in static cultures underneath minimal (M9) media stimulated immunity that led to 80–100% protection.

scholarly journals Antibiotic Susceptibility Pattern of Bacteria Isolated from an Urban Referral Hospital in Dhaka City

2016 ◽  
Vol 2 (2) ◽  
pp. 7-11
Author(s):  
M Mushfequr Rahman ◽  
J Ashraful Haq ◽  
MAH Golam Morshed ◽  
Farida Huq
Keyword(s):  
Antibiotic Susceptibility ◽  
Referral Hospital ◽  
Dhaka City ◽  
Bacterial Strains ◽  
Klebsiella Species ◽  
Acinetobacter Species ◽  
Pseudomonas Species ◽  
Judicious Choice ◽  
Almost All ◽  
First And Second Generation

The present study was to assess the pattern of antibiotic susceptibility of the isolated bacteria in an urban referral hospital in Dhaka City. A total of 393 bacterial strains were isolated from various specimens over a l0-months period. The majority of the organisms were Escherichia coli Q3.33oh) followed by Klebsiella species (27.480 ), Staphylococcas aureus (l7.Oioh),Lcinetobacter species (8.l4yo), Pseudomonas species (7.l2Yo), and others. The thirdgeneration Cephalosporins Hke Ceftriaxone, Ceftazidime and Cefotaxime were sensitive against 45-66yo isolated Enterobacteriaceae. The first- and second-generation Cephalosporins were less effective. The sensitivity to Ciprofloxacin of various Enterobacteriaceae was only between 33-4Oo compared to 52.8-67.9Vo against Gentamicin. Majority of the Enterobacteriaceae were resistant to Ampicillin, whereas almost all of the Enterobacteriaceae (94-100%o) were sensitive to Imipenem. Ahont97.UY;s Acinetobacter species were susceptible to Imipenem. Sensitivity of the organism (Acinetobacter) to third-generation Cephalosporins ranged between 50-560 , whereas 40.60/o were found sensitive to Ciprofloxacin. The sensitivity to Chloramphenicol, Co-trimoxazole, Cephalexin and Ampicillin ranged between 9.3oh to 34.30 . About 93.0%o of Pseudomonas species were sensitive to Imipenem. The rate of susceptibility to Gentamicin and Netilmicin was higher than those of the Ciprofloxacin and Ceftriaxone (67.80/o and, 53.57o vs, 39.2yo), About 707o of isolated S. aureus were resistant to OxacilHn but all were sensitive to Vancomycin. The result of this study would help the physicians to make a judicious choice of,.anti.biotics for therapeutic purposes.Bangladesh J Med Microbiol 2008; O2 (02):7-ll

scholarly journals Carbapenemase Genes and Multidrug Resistance of Acinetobacter Baumannii: A Cross Sectional Study of Patients with Pneumonia in Southern Vietnam

Antibiotics ◽  
2019 ◽  
Vol 8 (3) ◽  
pp. 148 ◽  
Author(s):  
Cuong Hoang Quoc ◽  
Thao Nguyen Thi Phuong ◽  
Hai Nguyen Duc ◽  
Trung Tran Le ◽  
Hang Tran Thi Thu ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Acinetobacter Baumannii ◽  
Demographic Data ◽  
Treatment Options ◽  
Bacterial Pathogen ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Carbapenem Resistant ◽  
Hospital Acquired

Background: Acinetobacter baumannii (Ab) is an opportunistic bacterial pathogen found in hospital-acquired infections including nosocomial pneumonia, especially multidrug-resistant Ab. This study aims to survey the drug resistance profiles of Ab isolated from patients in Thong Nhat Dong Nai General Hospital and assess the relationship between genotypes and antibiotic resistance; Methods: Ninety-seven Ab strains isolated from 340 lower respiratory tract specimens among pneumonia patients were used to screen the most common local carbapenemase genes. Antimicrobial susceptibility testing results and demographic data were collected and minimum inhibitory concentrations (MIC) of colistin were also determined; Results: Over 80% and 90% of Ab strains were determined as carbapenem-resistant and multidrug-resistant (MDR), respectively. Most of the strains carried carbapenemase genes, including blaOXA-51, blaOXA-23-like, blaOXA-58-like, and blaNDM-1, with proportions of 97 (100%), 76 (78.4%), 10 (10.3%), 6 (6.2%), respectively. Amongst these genes, blaOXA-23-like was the only gene which significantly influenced the resistance (p < 0.0001); and Conclusions: The severity of Ab antibiotic resistance is urgent and specifically related to carbapenemase encoding genes. Therefore, screening of MDR Ab and carbapenemase for better treatment options is necessary.

scholarly journals Alterations of Metabolic and Lipid Profiles in Polymyxin-ResistantPseudomonas aeruginosa

2018 ◽  
Vol 62 (6) ◽  
Author(s):  
Mei-Ling Han ◽  
Yan Zhu ◽  
Darren J. Creek ◽  
Yu-Wei Lin ◽  
Dovile Anderson ◽  
...  
Keyword(s):  
Lipid A ◽  
Therapeutic Option ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Wild Type ◽  
Metabolomics Data ◽  
Content Type ◽  
In The Wild ◽  
High Level ◽  
Acyl Coenzyme A

ABSTRACTMultidrug-resistantPseudomonas aeruginosapresents a global medical challenge, and polymyxins are a key last-resort therapeutic option. Unfortunately, polymyxin resistance inP. aeruginosahas been increasingly reported. The present study was designed to define metabolic differences between paired polymyxin-susceptible and -resistantP. aeruginosastrains using untargeted metabolomics and lipidomics analyses. The metabolomes of wild-typeP. aeruginosastrain K ([PAK] polymyxin B MIC, 1 mg/liter) and its pairedpmrBmutant strains, PAKpmrB6and PAKpmrB12(polymyxin B MICs of 16 mg/liter and 64 mg/liter, respectively) were characterized using liquid chromatography-mass spectrometry, and metabolic differences were identified through multivariate and univariate statistics. PAKpmrB6and PAKpmrB12, which displayed lipid A modifications with 4-amino-4-deoxy-l-arabinose, showed significant perturbations in amino acid and carbohydrate metabolism, particularly the intermediate metabolites from 4-amino-4-deoxy-l-arabinose synthesis and the methionine salvage cycle pathways. The genomics result showed a premature termination (Y275stop) inspeE(encoding spermidine synthase) in PAKpmrB6, and metabolomics data revealed a decreased intracellular level of spermidine in PAKpmrB6compared to that in PAKpmrB12. Our results indicate that spermidine may play an important role in high-level polymyxin resistance inP. aeruginosa. Interestingly, bothpmrBmutants had decreased levels of phospholipids, fatty acids, and acyl-coenzyme A compared to those in the wild-type PAK. Moreover, the more resistant PAKpmrB12mutant exhibited much lower levels of phospholipids than the PAKpmrB6mutant, suggesting that the decreased phospholipid level was associated with polymyxin resistance. In summary, this study provides novel mechanistic information on polymyxin resistance inP. aeruginosaand highlights its impacts on bacterial metabolism.

scholarly journals Novel Engineered Peptides of a Phage Lysin as Effective Antimicrobials against Multidrug-Resistant Acinetobacter baumannii

2016 ◽  
Vol 60 (5) ◽  
pp. 2671-2679 ◽  
Author(s):  
Mya Thandar ◽  
Rolf Lood ◽  
Benjamin Y. Winer ◽  
Douglas R. Deutsch ◽  
Chad W. Euler ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Bacterial Pathogen ◽  
Antibacterial Activities ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Gram Negative ◽  
Content Type ◽  
Human Red Blood Cells ◽  
Phage Lysin

ABSTRACTAcinetobacter baumanniiis a Gram-negative bacterial pathogen responsible for a range of nosocomial infections. The recent rise and spread of multidrug-resistantA. baumanniiclones has fueled a search for alternative therapies, including bacteriophage endolysins with potent antibacterial activities. A common feature of these lysins is the presence of a highly positively charged C-terminal domain with a likely role in promoting outer membrane penetration. In the present study, we show that the C-terminal amino acids 108 to 138 of phage lysin PlyF307, named P307, alone were sufficient to killA. baumannii(>3 logs). Furthermore, P307 could be engineered for improved activity, the most active derivative being P307SQ-8C(>5-log kill). Both P307 and P307SQ-8Cshowed highin vitroactivity againstA. baumanniiin biofilms. Moreover, P307SQ-8Cexhibited MICs comparable to those of levofloxacin and ceftazidime and acted synergistically with polymyxin B. Although the peptides were shown to kill by disrupting the bacterial cytoplasmic membrane, they did not lyse human red blood cells or B cells; however, serum was found to be inhibitory to lytic activity. In a murine model ofA. baumanniiskin infection, P307SQ-8Creduced the bacterial burden by ∼2 logs in 2 h. This study demonstrates the prospect of using peptide derivatives from bacteriophage lysins to treat topical infections and remove biofilms caused by Gram-negative pathogens.

scholarly journals Aerosolized Hypertonic Saline Hinders Biofilm Formation to Enhance Antibiotic Susceptibility of Multidrug-Resistant Acinetobacter baumannii

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1115
Author(s):  
Hui-Ling Lin ◽  
Chen-En Chiang ◽  
Mei-Chun Lin ◽  
Mei-Lan Kau ◽  
Yun-Tzu Lin ◽  
...  
Keyword(s):  
Particle Size ◽  
Particle Size Distribution ◽  
Acinetobacter Baumannii ◽  
Hypertonic Saline ◽  
Antibiotic Susceptibility ◽  
Biofilm Formation ◽  
Therapeutic Strategy ◽  
Extracellular Polymeric Substances ◽  
Multidrug Resistant ◽  
Biofilm Disruption

Limited therapeutic options are available for multidrug-resistant Acinetobacter baumannii (MDR-AB), and the development of effective treatments is urgently needed. The efficacy of four aerosolized antibiotics (gentamicin, amikacin, imipenem, and meropenem) on three different MDR-AB strains was evaluated using hypertonic saline (HS, 7 g/100 mL) as the aerosol carrier. HS aerosol effectively hindered biofilm formation by specific MDR-AB strains. It could also interrupt the swarming dynamics of MDR-AB and the production of extracellular polymeric substances, which are essential for biofilm progression. Biofilms protect the microorganisms from antibiotics. The use of HS aerosol as a carrier resulted in a decreased tolerance to gentamicin and amikacin in the biofilm-rich MDR-AB. Moreover, we tested the aerosol characteristics of antibiotics mixed with HS and saline, and results showed that HS enhanced the inhaled delivery dose with a smaller particle size distribution of the four antibiotics. Our findings demonstrate the potential of using “old” antibiotics with our “new” aerosol carrier, and potentiate an alternative therapeutic strategy to eliminate MDR-AB infections from a biofilm-disruption perspective.

scholarly journals MULTIDRUG-RESISTANT ACINETOBACTER BAUMANNII (MDRAB) PREVALENCE AND CHARACTERISTICS IN DR.WAHIDIN SUDIROHUSODO GENERAL HOSPITAL OF MAKASSAR

2019 ◽  
Vol 25 (2) ◽  
pp. 211
Author(s):  
Dewi Tungadi ◽  
Nurhayana Sennang ◽  
Benny Rusli
Keyword(s):  
Length Of Stay ◽  
Acinetobacter Baumannii ◽  
General Hospital ◽  
Average Length ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Infection Prevention And Control ◽  
Average Length Of Stay ◽  
Improve Hospital ◽  
And Control

BackgroundMultidrug-resistant Acinetobacter baumannii (MDRAB) is a strain of Acinetobacter baumannii which is resistant to three or more classes of antibiotics. As prevalence of MDRAB increases, the antibiotics of choice become limited. Identification of MDRAB is required to manage and control infection.MethodThis was a retrospective study, conducted in Dr. Wahidin Sudirohusodo General Hospital of Makassar, dated from January to December 2016. Bacterial identification and antimicrobial susceptibility testing (AST) were performed using VITEK 2. The patient data were obtained from electronic medical records.Results and DiscussionA total of 323 Acinetobacter baumannii isolates were obtained, consisted of 188 isolates in January-June 2016 and 36 of which was MDRAB (19.15%) with the average length-of-stay 33 days; and 135 isolates in July-December 2016 and 31 of which was MDRAB (22.96%) with the average length-of-stay 27 days. MDRAB was mostly discovered from patients using 3 or more medical devices and on single antibiotic therapy. MDRAB isolates were mostly obtained in sputum and pus specimens, and majority of patients had respiratory diseases. The result of AST showed 100% and 96% susceptibility to Polymyxin B; 71.43% and 54.84% susceptibility to Amikacin; 66.67% and 50% susceptibility to Trimethoprim/Sulfamethoxazole in January-June and July-December 2016, respectively.Conclusion and SuggestionsThe prevalence of MDRAB in our hospital in 2016 was high, suggesting the needs to improve hospital infection prevention and control. Polymyxin B, Amikacin, and Trimethoprim/Sulfamethoxazole are the antibiotics of choice to treat MDRAB.

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