High mortality rates among solid organ transplant recipients infected with extensively drug-resistant Acinetobacter baumannii: using in vitro antibiotic combination testing to identify the combination of a carbapenem and colistin as an effective treatment regimen

Ryan K Shields; Eun J Kwak; Brian A Potoski; Yohei Doi; Jennifer M Adams-Haduch; Fernanda P Silviera; Yoshiya Toyoda; Joseph M Pilewski; Maria Crespo; A William Pasculle; Cornelius J Clancy; M Hong Nguyen

doi:10.1016/j.diagmicrobio.2010.12.023

High mortality rates among solid organ transplant recipients infected with extensively drug-resistant Acinetobacter baumannii: using in vitro antibiotic combination testing to identify the combination of a carbapenem and colistin as an effective treatment regimen

Diagn Microbiol Infect Dis. 2011 Jun;70(2):246-52. doi: 10.1016/j.diagmicrobio.2010.12.023. Epub 2011 Feb 25.

Authors

Ryan K Shields¹, Eun J Kwak, Brian A Potoski, Yohei Doi, Jennifer M Adams-Haduch, Fernanda P Silviera, Yoshiya Toyoda, Joseph M Pilewski, Maria Crespo, A William Pasculle, Cornelius J Clancy, M Hong Nguyen

Affiliation

¹ University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA.

PMID: 21353436
DOI: 10.1016/j.diagmicrobio.2010.12.023

Abstract

Extensively drug-resistant (XDR) Acinetobacter baumannii infections caused 91% (10/11) mortality in transplant recipients. Isolates were colistin-susceptible initially, but susceptibility decreased during therapy in 40% (4/10). We tested antibiotic combinations against XDR Acinetobacter in vitro and demonstrated positive interactions for carbapenem-colistin. Subsequently, 80% (4/5) of transplant patients were treated successfully with carbepenem-colistin regimens.

Published by Elsevier Inc.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acinetobacter Infections / drug therapy
Acinetobacter Infections / microbiology
Acinetobacter Infections / mortality*
Acinetobacter baumannii / drug effects*
Acinetobacter baumannii / isolation & purification
Adult
Aged
Anti-Bacterial Agents / administration & dosage*
Anti-Bacterial Agents / pharmacology
Carbapenems / administration & dosage
Carbapenems / pharmacology
Colistin / administration & dosage
Colistin / pharmacology
Drug Resistance, Multiple, Bacterial*
Drug Synergism
Drug Therapy, Combination / methods*
Female
Humans
Male
Microbial Sensitivity Tests
Microbial Viability
Middle Aged
Organ Transplantation*
Transplantation*
Treatment Outcome

Substances

Anti-Bacterial Agents
Carbapenems
Colistin