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Beta-Lactamase Inhibitors
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Pascalis Vergidis, Matthew E. Falagas
Other drug combinations have been studied in the management of Acinetobacter infections. In three studies, combination treatment was associated with a survival benefit. The combinations used were carbapenem with ampicillin–sulbactam (Kuo et al., 2007); carbapenem with colistin (Shields et al., 2012); and combinations of colistin with rifampin, sulbactam with aminoglycosides, tigecycline with colistin and rifampin, and tigecycline with rifampin and amikacin (Hernandez-Torres et al., 2012). This survival benefit has not been validated in other combination treatment studies.
Acinetobacter Species: Resistance Update and Treatment Options
Published in Robert C. Owens, Lautenbach Ebbing, Antimicrobial Resistance, 2007
Lisa L. Maragakis, Trish M. Perl
Acinetobacter is a rapidly emerging pathogen in the healthcare setting, where it causes healthcare-associated infections including bacteremia, pneumonia, meningitis, urinary tract infections, and wound infections. Properties of A. baumannii, such as its ability to survive under a wide range of environmental conditions and to persist for extended periods of time on environmental surfaces, make it a frequent cause of outbreaks as well as an endemic pathogen in the healthcare setting (2). Risk factors for colonization or infection with A. baumannii include prolonged length of hospital stay, exposure to ICUs and mechanical ventilation, antimicrobial use, recent surgery, invasive procedures, and underlying severity of illness (Table 1) (2).
Epidemiology of Acinetobacter spp.: Surveillance and Management of Outbreaks
Published in E. Bergogne-Bénézin, M.L. Joly-Guillou, K.J. Towner, Acinetobacter, 2020
M.-L. Joly-Guillou, C. Brun-Buisson
Acinetobacter spp. currently represent 2-5% of all isolates recovered in hospital clinical microbiology laboratories. Infections caused by Acinetobacter spp. are caused predominantly by A. baumannii (approximating to the former A. anitratus ssp. anitratus), while infections caused by other Acinetobacter spp. are relatively infrequent, with the exception of some rare outbreaks. Reports from France indicate that the propor-tion of A. baumannii isolates has increased from 75% of all Acinetobacter hospital isolates in the decade 1970-1980 to 90-95% of Acinetobacter isolates in the decade 1980-1990 (Joly-Guillou and Bergogne-Bérézin, 1985; 1990). These changes were associated with an increase in the proportion of isolates that were resistant to £-lactams and aminoglycosides. In 1990, 84% of isolates were multiresistant to B- lactams and 64% of isolates were resistant to aminoglycosides, although it should be noted that >50% of isolates in this survey were of two distinct phage types, indicating a high proportion of epidemic strains. In hospitals participating in the NNIS surveillance programme in the U.S., acinetobacter accounted for 0.76% of nosocomial respiratory tract infections in ICUs in the years 1974-1977, and for 6.4% in the years 1985-1990 (Jarvis and Martone, 1992). Struelens et al. (1993) reported that A. baumannii accounted for 0.3% of endemic nosocomial infection in ICU patients, and for 1% of nosocomial bacteraemias. An increase in nosocomial infections caused by Acinetobacter spp. has been recorded during the summer months in several reports (Ramphal and Kluge, 1979; Retailliau et al., 1979). This seasonal increase has not been explained satisfactorily, although temperature and humidity conditions during the summer are possible predisposing factors for overgrowth of Acinetobacter in the environment or in patients.
Traumatic cervical posterior spondyloptosis: report of a rare case
Published in British Journal of Neurosurgery, 2023
Arash Fattahi, Alireza Tabibkhooei
After reduction, we performed an anterior cervical approach for C5 corpectomy followed by iliac autograft and plate fixation (Figure 1(d)). After two days, we found cerebrospinal fluid leakage from one of removed traction screw sites in the absence of any coexisting skull fracture, which was sutured under a sterile condition in the ICU but in the next few days she developed fulminate hospital-acquired meningitis which led to hydrocephalus. Bacteriologic studies revealed Acinetobacter as the causative organism. Using intravenous antibiotics and external ventricular drainage, the meningitis resolved with negative culture results and about two months later, a ventriculoperitoneal shunt was placed for final management of the hydrocephalus. Despite successful treatment of the meningitis, hospital-acquired pneumonia led to severe pleural effusion that was drained and ultimately to her death about three months after admission.
Carbapenem-resistant Gram-negative pathogens associated with septic shock: a review of 120 cases
Published in Journal of Chemotherapy, 2022
Uğur Önal, Deniz Akyol, Merve Mert, Dilşah Başkol, Seichan Chousein Memetali, Gamze Şanlıdağ, Buse Kenanoğlu, Ayşe Uyan-Önal, Günel Quliyeva, Cansu Bulut Avşar, Damla Akdağ, Melike Demir, Hüseyin Aytaç Erdem, Ümit Kahraman, Osman Bozbıyık, Erkin Özgiray, Devrim Bozkurt, Funda Karbek Akarca, Kubilay Demirağ, İlkin Çankayalı, Mehmet Uyar, Feriha Çilli, Bilgin Arda, Tansu Yamazhan, Hüsnü Pullukçu, Meltem Işıkgöz Taşbakan, Hilal Sipahi, Sercan Ulusoy, Oguz Resat Sipahi
The infecting pathogens were Acinetobacter spp. (49.2%, 59/120), Klebsiella spp. (45.8% 55/120), and Pseudomonas aeruginosa (13.3%, 16/120). All strains were MDR. The sources of the positive bacteriological culture results for CRGNP were urine cultures (39.1%, 47/120), peripheral or catheter blood cultures (36.7%, 44/120), and respiratory tract specimens’ cultures (34.2%, 41/120). Among the patients with positive peripheral or catheter blood cultures, the concomitant bacterial culture positivity rate was 36.4% (16/44) for urinary cultures, 22.7% (10/44) for respiratory tract cultures, and 15.9% (7/44) for other cultures. Further, Acinetobacter spp. culture positivity was found to be significantly higher in the respiratory tract specimens versus others (46%, 27/59 versus 23%, 14/61, P = 0.008).
New perspectives in the antibiotic treatment of mechanically ventilated patients with infections from Gram-negatives
Published in Expert Review of Anti-infective Therapy, 2021
Marios Karvouniaris, Konstantinos Pontikis, Thomas Nitsotolis, Garyphallia Poulakou
The APEKS-NP study, a multicenter phase III study, juxtaposed cefiderocol 2 g thrice daily to extended-infusion meropenem 2 g thrice daily for the treatment of HAP/VAP [104]. The study drug showed non-inferiority compared to meropenem regarding the primary outcome of 14-day all-cause mortality (Table 2). No difference was demonstrated regarding the predefined subgroup of ventilated patients [104]. Concerning Acinetobacter spp. pneumonia, the primary outcome was met in 19% vs. 22%. Similarly, when the study participants presented infection from Acinetobacter spp. with a meropenem MIC higher than 64 mg/L (16 patients), the respective mortality proportions were 0% and 46% (non-significant).