In Vitro Activity of #Minocycline against #US Isolates of #Acinetobacter baumannii – Acinetobacter calcoaceticus species complex, …: Results from the SENTRY Antimicrobial Surveillance Program (2014-2018) (Antimicrob Agents Chemother., abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

In Vitro Activity of Minocycline against U.S. Isolates of Acinetobacter baumannii-Acinetobacter calcoaceticus species complex, Stenotrophomonas maltophilia, and Burkholderia cepacia complex: Results from the SENTRY Antimicrobial Surveillance Program (2014-2018)

Robert K. Flamm, Dee Shortridge, Mariana Castanheira, Helio S. Sader, Michael A. Pfaller

DOI: 10.1128/AAC.01154-19

 

ABSTRACT

We evaluated the activity of minocycline and comparator agents against a large number of Stenotrophomonas maltophilia (n = 1,289), Acinetobacter baumannii-Acinetobacter calcoaceticus species complex (n = 1,081), and Burkholderia cepacia complex (n = 101) collected during 2014 through 2018 from 87 U.S. medical centers spanning all nine census divisions. The isolates were collected primarily from hospitalized patients with pneumonia (1,632 isolates; 66.0% overall), skin and skin structure infections (354 isolates; 14.3% overall), bloodstream infections (266 isolates; 10.8% overall), urinary tract infections (126 isolates; 5.1% overall), intra-abdominal infections (61 isolates; 2.5% overall), and other infections (32 isolates; 1.3% overall). Against A. baumannii-A. calcoaceticus species complex, colistin was the most active agent exhibiting MIC50/90 values at ≤0.5/2 μg/ml and 92.4% susceptible. Minocycline ranked second in activity with MIC50/90 values at 0.25/8 μg/ml and susceptibility at 85.7%. Activity for these two agents was reduced against extensively drug-resistant and multidrug-resistant isolates of Acinetobacter baumannii-Acinetobacter calcoaceticus species complex. Only two agents showed high levels of activity (susceptibility >90%) against S. maltophilia: minocycline (MIC50/90, 0.5/2 μg/ml; 99.5% susceptible) and trimethoprim-sulfamethoxazole (MIC50/90, ≤0.5/1 μg/ml; 94.6% susceptible). Minocycline was active against 92.8% (MIC90, 4 μg/ml) of trimethoprim-sulfamethoxazole-resistant S. maltophilia isolates. Various agents exhibited susceptibility rates of nearly 90% against B. cepacia complex: trimethoprim-sulfamethoxazole (MIC50/90, ≤0.5/2 μg/ml; 93.1% susceptible), ceftazidime (MIC50/90, 2/8 μg/ml; 91.0%), meropenem (MIC50/90, 2/8 μg/ml; 89.1%) and minocycline (MIC50/90, 2/8 μg/ml; 88.1% susceptible). These results indicate that minocycline is among the most active agents for these three problematic potential pathogen groups when tested against U.S. isolates.

Copyright © 2019 American Society for Microbiology. All Rights Reserved.

Keywords: Antibiotics; Drugs Resistance; Minocycline; Colistin; Acinetobacter baumannii; Burkholderia cepacia; USA.

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#Factors associated with #fatality due to #avian #influenza A(#H7N9) #infection in #China (Clin Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Clin Infect Dis. 2019 Aug 16. pii: ciz779. doi: 10.1093/cid/ciz779. [Epub ahead of print]

Factors associated with fatality due to avian influenza A(H7N9) infection in China.

Zheng S1,2,3, Zou Q2,3, Wang X2,3, Bao J2,3, Yu F2,3, Guo F4, Liu P5, Shen Y6, Wang Y7, Yang S1, Wu W1, Sheng J1, Vijaykrishna D8,9, Gao H1,4, Chen Y1,2,3.

Author information: 1 State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, P.R. China. 2 Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, P.R. China. 3 Center of Clinical Laboratory, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, P.R. China. 4 Department of Infectious Diseases, Shulan (Hangzhou) Hospital, Hangzhou, P.R. China. 5 Department of Infectious Diseases, The second hospital of Ningbo, Ningbo, P.R. China. 6 Department of Infectious and Immune Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, P.R. China. 7 Department of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, P.R. China. 8 Department of Microbiology, Biomedicine Discovery Institute, Monash University, Victoria, Australia. 9 World Health Organization Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.

 

Abstract

BACKGROUND:

The high case fatality rate of influenza A H7N9 infected patients has been a major clinical concern.

METHODS:

To identify the common causes of death due to H7N9 as well as identify risk factors associated with the high inpatient mortality, we retrospectively collected clinical treatment information from 350 hospitalized human cases of H7N9 virus in mainland China during 2013-2017, of which 109 (31.1%) had died, and systematically analysed the patient’s clinical characteristics and risk factors for death.

RESULTS:

The median age of infection was 57 years, whereas the median age of mortality was 61 years, significantly older than those survived. In contrast to previous studies, we found nosocomial infections, comprising Acinetobacter baumannii and Klebsiella most commonly associated with secondary bacterial infections, which was likely due to the high utilization of supportive therapies, including mechanical ventilation (52.6%), ECMO (14%), CRRT (19.1%), and artificial liver therapy (9.7%). Age, time from illness onset to antiviral therapy initiation and secondary bacterial infection were independent risk factors for death. Age >65, secondary bacterial infections, and initiation of neuraminidase inhibitors therapy after 5 days from symptom onset were associated with increased risk of death.

CONCLUSIONS:

Fatality among H7N9 virus infected patients occurred rapidly after hospital admission, especially among older patients, and was followed by severe hypoxemia and multisystem organ failure. Our results show that early neuraminidase-inhibitor therapy and reduction of secondary bacterial infections can help reduce mortality.

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

KEYWORDS: H7N9; Influenza; Risk factors; zoonotic infection

PMID: 31418813 DOI: 10.1093/cid/ciz779

Keywords: Antivirals; Antibiotics; Avian Influenza; H7N9; Human; China; Klebsiella pneumoniae; Acinetobacter baumannii.

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#Therapeutic efficacy of LN-1-255 in combination with #imipenem in severe #infection caused by #carbapenem-resistant #Acinetobacter baumannii (Antimicrob Agents Chemother., abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Therapeutic efficacy of LN-1-255 in combination with imipenem in severe infection caused by carbapenem-resistant Acinetobacter baumannii

Juan Carlos Vázquez-Ucha, Marta Martínez-Guitián, María Maneiro, Kelly Conde-Pérez, Laura Álvarez-Fraga, Gabriel Torrens, Antonio Oliver, John D. Buynak, Robert A. Bonomo,Germán Bou, Concepción González-Bello, Margarita Poza, Alejandro Beceiro

DOI: 10.1128/AAC.01092-19

 

ABSTRACT

OBJETIVES:

The Carbapenem-Hydrolyzing Class D β-Lactamases (CHDLs) are the main mechanism of carbapenem resistance in A. baumannii. CHDLs are not effectively inactivated by clinically available β-lactam-type inhibitors. We have previously described the in vitroefficacy of the inhibitor LN-1-255 in combination with carbapenems. The aim of this study was to compare the efficacy of LN-1-255 with that of imipenem in murine pneumonia using A. baumannii strains carrying their most extended carbapenemases: OXA-23 and OXA-24/40.

METHODS:

The blaOXA-23 and blaOXA-24/40 genes were cloned into carbapenem-susceptible A. baumannii ATCC 17978 strain. Clinical isolates AB1 and JC12/04, producing the enzymes OXA-23 and OXA-24/40, respectively, were used in the study. Pharmacokinetic parameters were determined. An experimental pneumonia model was used to evaluate the efficacy of the combined imipenem/LN-1-255 therapy.

RESULTS:

MICs of imipenem decreased between 32 and 128-fold in presence of LN-1-255. Intramuscular treatment with imipenem/LN-1-255 (30/50 mg/Kg) decreased the bacterial burden i) 4 and 1.7 log10 CFU/g lung in the infection with the ATCC 17978-OXA-23 and the AB1 strains, respectively and ii) 2.5 and 4.5 log10 CFU/g lung the infection produced by the ATCC 17978-OXA-24/40 and the JC12/04 strains, respectively. In all assays combined therapy offered higher protection against pneumonia than those treated with monoteraphy. No toxicity was observed in treated mice.

CONCLUSIONS:

Imipenem treatment combined with LN-1-255 reduced significantly the severity of infection by carbapenem-resistant A. baumannii strains carrying CHDLs. Preclinical assays demonstrated the potential of the therapy of LN-1-255 and imipenem as new antibacterial treatment.

Copyright © 2019 American Society for Microbiology. All Rights Reserved.

Keywords: Antibiotics; Drugs Resistance; Carbapenem; Imipenem; Acinetobacter baumannii; Animal models.

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Efficacy and safety of #tigecycline in #treatment of #pneumonia caused by #MDR Acinetobacter baumannii: a systematic review and meta-analysis (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

Efficacy and safety of tigecycline in treatment of pneumonia caused by MDR Acinetobacter baumannii: a systematic review and meta-analysis

Hekun Mei, Tianli Yang, Jin Wang, Rui Wang, Yun Cai

Journal of Antimicrobial Chemotherapy, dkz337, https://doi.org/10.1093/jac/dkz337

Published: 03 August 2019

 

Abstract

Background

Use of tigecycline in treating MDR Acinetobacter baumannii (MDRAB) remains controversial.

Objectives

To comprehensively assess the safety and efficacy of tigecycline in pneumonia caused by Acinetobacter baumannii.

Methods

PubMed, Embase, Web of Science and Cochrane library databases were searched up to 12 March 2019. Studies were included if they compared tigecycline-based regimens with other antibiotic regimens for treating AB pulmonary infections and we pooled the clinical outcomes, microbiological response, adverse events or mortality.

Results

One prospective study and nine retrospective studies were included in this meta-analysis. The results showed similar clinical cure rates (OR = 1.04, 95% CI = 0.60–1.81; P = 0.89) and mortality rates (OR = 1.11, 95% CI = 0.65–1.89; P = 0.71) comparing tigecycline groups with the control groups. However, a significantly lower microbiological eradication rate was found in the tigecycline groups (OR = 0.43, 95% CI = 0.27–0.66; P = 0.0001). Incidence of nephrotoxicity in tigecycline-based regimens was significantly lower than in colistin-based regimens (OR = 0.34, 95% CI = 0.16–0.74, I2 = 35%, P = 0.006). There were no randomized controlled trials (RCTs) included; incomplete safety data and regional bias caused by the majority of the studies originating in China are the main limitations of this meta-analysis.

Conclusions

Tigecycline can be used for treating MDRAB pulmonary infections owing to efficacy similar to that of other antibiotics. Moreover, tigecycline did not show a higher risk of mortality. Considering the lower microbiological eradication rate for tigecycline, which is likely to induce antimicrobial resistance, well-designed RCTs for high-dose tigecycline in treating pneumonia caused by AB are still needed.

Topic: colistin – pneumonia – safety – mortality – acinetobacter baumannii – nephrotoxicity – tigecycline – adverse event

Issue Section: Systematic review

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Antibiotics; Drugs Resistance; Tigecycline; Acinetobacter baumannii; Pneumonia.

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Successful #treatment with #cefiderocol for #compassionate use in a critically ill #patient with #XDR #Acinetobacter baumannii and KPC-producing #Klebsiella pneumoniae: a case report (J Antimicrob Chemother., summary)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Summary, edited.]

Successful treatment with cefiderocol for compassionate use in a critically ill patient with XDR Acinetobacter baumannii and KPC-producing Klebsiella pneumoniae: a case report

Enrico Maria Trecarichi, Angela Quirino, Vincenzo Scaglione, Federico Longhini,Eugenio Garofalo, Andrea Bruni, Eugenio Biamonte, Rosaria Lionello,Francesca Serapide, Maria Mazzitelli, Nadia Marascio, Giovanni Matera,Maria Carla Liberto, Paolo Navalesi, Carlo Torti, IMAGES Group

Journal of Antimicrobial Chemotherapy, dkz318, https://doi.org/10.1093/jac/dkz318

Published: 01 August 2019

___

Sir,

Cefiderocol is a new siderophore cephalosporin, with potent activity against MDR Gram-negative bacilli. It is particularly active against XDR Acinetobacter baumannii(Ab) infections, for which treatment options are quite limited.1–3 Herein, we describe a case of an adult male patient with severe H1N1 influenza complicated by ventilator-associated pneumonia (VAP) and bloodstream infection (BSI) caused by XDR Ab and carbapenemase-producing Klebsiella pneumoniae (KPC-Kp). Nothing remarkable was in his medical history apart from favism and Aarskog–Scott syndrome. In February 2019, due to the onset of acute respiratory failure, he was admitted to a peripheral primary ICU where he was diagnosed with H1N1 influenza…

(…)

____

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Antibiotics; Drugs Resistance; Carbapenem; Acinetobacter baumannii; Klebsiella pneumoniae; Seasonal Influenza; H1N1pdm09; Pneumonia; Cefiderocol.

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Complete nucleotide #sequences of #mcr-4.3-carrying #plasmids in #Acinetobacter baumannii ST345 of #human and #food origin from the #Czech Republic; first case in Europe (Antimicrob Agents Chemother., abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Complete nucleotide sequences of mcr-4.3-carrying plasmids in Acinetobacter baumannii ST345 of human and food origin from the Czech Republic; first case in Europe.

Ibrahim Bitar, Matej Medvecky, Tereza Gelbicova, Vladislav Jakubu, Jaroslav Hrabak, Helena Zemlickova, Renata Karpiskova, Monika Dolejska

DOI: 10.1128/AAC.01166-19

 

ABSTRACT

Here we describe two plasmids carrying mcr-4.3 in two Acinetobacter baumannii strains isolated from imported food and a clinical sample. The comparative analysis of these plasmids, with two other plasmids reported in NCBI database, highlighted the common origin of the plasmidic structure carrying mcr-4.3. This is the first case of mcr-4.3 gene in A. baumanniistrain isolated from a clinical case in Europe. We hypothesize that food import is initiating the spread in Czech Republic.

Copyright © 2019 American Society for Microbiology. All Rights Reserved.

Keywords: Antibiotics; Drugs Resistance; Colistin; MCR4.3; Acinetobacter baumannii; Human; Food safety; Czech Republic; Plasmids.

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Activity of #cefepime / #zidebactam (WCK 5222) against #Enterobacteriaceae, #Pseudomonas aeruginosa and #Acinetobacter baumannii endemic to #NYC #medical centres (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

Activity of cefepime/zidebactam (WCK 5222) against Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii endemic to New York City medical centres

Zeb Khan, Alejandro Iregui, David Landman, John Quale

Journal of Antimicrobial Chemotherapy, dkz294, https://doi.org/10.1093/jac/dkz294

Published: 11 July 2019

 

Abstract

Background

The combination of cefepime and zidebactam (WCK5222), a novel β-lactam enhancer, has demonstrated activity against a wide variety of Gram-negative pathogens and is currently under clinical evaluation.

Objectives

To examine the activity of cefepime/zidebactam against: (i) a contemporary collection of Gram-negative isolates from New York City; (ii) a collection of carbapenem-resistant clinical isolates; and (iii) a collection of isolates with characterized resistance mechanisms.

Methods

Susceptibility tests were performed using broth microdilution for cefepime, zidebactam and cefepime/zidebactam (1:1).

Results

More than 99% of a contemporary collection of Escherichia coli, Klebsiella pneumoniae and Enterobacter spp. had cefepime/zidebactam MICs ≤2 mg/L, the susceptibility breakpoint for cefepime. For K. pneumoniae, the acquisition of blaKPC resulted in increased MICs, although MICs remained ≤2 mg/L for 90% of KPC-possessing isolates. Overall for Pseudomonas aeruginosa, 98% of isolates had MICs ≤8 mg/L and MICs were affected by increased expression of ampC. For carbapenem-resistant P. aeruginosa, 78% of isolates had cefepime/zidebactam MICs ≤8 mg/L. The activity of cefepime/zidebactam against Acinetobacter baumannii was lower, with 85% of all isolates and 34% of carbapenem-resistant isolates with MICs ≤8 mg/L (cefepime interpretative criteria).

Conclusions

Cefepime/zidebactam demonstrated excellent activity against Enterobacteriaceae and P. aeruginosa, although activity was reduced in carbapenem-non-susceptible isolates. The activity against A. baumannii was reduced and studies examining the therapeutic efficacy in strains with high cefepime/zidebactam MICs are warranted.

Topic:  pseudomonas aeruginosa – cefepime – enterobacter – enterobacteriaceae – new york city – acinetobacter baumannii – bacterial carbapenemase resistance blakpc gene – malnutrition-inflammation-cachexia syndrome – carbapenem resistance

Issue Section: ORIGINAL RESEARCH

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Antibiotics; Drugs Resistance; Carbapenem; Enterobacteriaceae; Pseudomonas aeruginosa; Acinetobacter baumannii; Cefepine; Zidebactam; USA; NYC.

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