Acinetobacter baumannii Antibiotic Resistance Mechanisms

Pathogens, Journal Year: 2021, Volume and Issue: 10(3), P. 373 - 373

Published: March 19, 2021

Acinetobacter baumannii is a Gram-negative ESKAPE microorganism that poses threat to public health by causing severe and invasive (mostly nosocomial) infections linked with high mortality rates. During the last years, this pathogen displayed multidrug resistance (MDR), mainly due extensive antibiotic abuse poor stewardship. MDR isolates are associated medical history of long hospitalization stays, presence catheters, mechanical ventilation, while immunocompromised severely ill hosts predispose infections. Next-generation sequencing techniques have revolutionized diagnosis A. infections, contributing timely personalized therapeutic regimens according identification respective genes. The aim review describe in detail all current knowledge on genetic background mechanisms humans as regards beta-lactams (penicillins, cephalosporins, carbapenems, monobactams, beta-lactamase inhibitors), aminoglycosides, tetracyclines, fluoroquinolones, macrolides, lincosamides, streptogramin antibiotics, polymyxins, others (amphenicols, oxazolidinones, rifamycins, fosfomycin, diaminopyrimidines, sulfonamides, glycopeptide, lipopeptide antibiotics). Mechanisms antimicrobial refer regulation transportation through bacterial membranes, alteration target site, enzymatic modifications resulting neutralization. Virulence factors may affect susceptibility profiles confer drug also being discussed. Reports from cases coinfection SARS-CoV-2 during COVID-19 pandemic terms genes been investigated.

Language: Английский

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Cefiderocol: Systematic Review of Mechanisms of Resistance, Heteroresistance and In Vivo Emergence of Resistance

Antibiotics, Journal Year: 2022, Volume and Issue: 11(6), P. 723 - 723

Published: May 27, 2022

Cefiderocol appears promising, as it can overcome most β-lactam resistance mechanisms (including β-lactamases, porin mutations, and efflux pumps). Resistance is uncommon according to large multinational cohorts, including against isolates resistant carbapenems, ceftazidime/avibactam, ceftolozane/tazobactam, colistin. However, alarming proportions of have been reported in some recent cohorts (up 50%). A systematic review was conducted PubMed Scopus from inception May 2022 resistance, prevalence heteroresistance, vivo emergence cefiderocol during treatment. variety mechanisms, typically acting concert, confer cefiderocol: β-lactamases (especially NDM, KPC AmpC variants conferring OXA-427, PER- SHV-type ESBLs), mutations affecting siderophore receptors, pumps, target (PBP-3) modifications. Coexpression multiple often combination with permeability defects, be the main mechanism resistance. Heteroresistance highly prevalent A. baumannii), but its clinical impact unclear, considering that low studies. Nevertheless, cases emerging are increasingly being reported. Continued surveillance cefiderocol’s activity important this agent introduced practice.

Language: Английский

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The Revival of Aztreonam in Combination with Avibactam against Metallo-β-Lactamase-Producing Gram-Negatives: A Systematic Review of In Vitro Studies and Clinical Cases

Antibiotics, Journal Year: 2021, Volume and Issue: 10(8), P. 1012 - 1012

Published: Aug. 20, 2021

Infections caused by metallo-β-lactamase (MBL)-producing Enterobacterales and Pseudomonas are increasingly reported worldwide usually associated with high mortality rates (>30%). Neither standard therapy nor consensus for the management of these infections exist. Aztreonam, an old β-lactam antibiotic, is not hydrolyzed MBLs. However, since many MBL-producing strains co-produce enzymes that could hydrolyze aztreonam (e.g., AmpC, ESBL), a robust β-lactamase inhibitor such as avibactam be given partner drug. We performed systematic review including 35 in vitro 18 vivo studies on combination + sustained Gram-negatives. In data 2209 Gram-negatives were available, showing antimicrobial activity (MIC ≤ 4 mg/L when combined avibactam) 80% Enterobacterales, 85% Stenotrophomonas 6% Pseudomonas. Clinical available 94 patients: 83% them had bloodstream infections. resolution within 30 days was infected patients. Analyzing only patients (64 patients), death occurred 19% treated ceftazidime/avibactam. The appears to promising option against bacteria (especially much less Pseudomonas) while waiting new antimicrobials.

Language: Английский

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Global prevalence of cefiderocol non-susceptibility in Enterobacterales, Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia: a systematic review and meta-analysis

Clinical Microbiology and Infection, Journal Year: 2023, Volume and Issue: 30(2), P. 178 - 188

Published: Sept. 4, 2023

Language: Английский

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The Evolution of Antimicrobial Resistance in Acinetobacter baumannii and New Strategies to Fight It

Antibiotics, Journal Year: 2025, Volume and Issue: 14(1), P. 85 - 85

Published: Jan. 14, 2025

Acinetobacter baumannii is considered one of the prioritized ESKAPE microorganisms for research and development novel treatments by World Health Organization, especially because its remarkable persistence drug resistance. In this review, we describe how can be acquired enzymatic degradation antibiotics, target site modification, altered membrane permeability, multidrug efflux pumps, their ability to form biofilms. Also, evolution resistance in A. baumannii, which mainly driven mobile genetic elements, reported, with particular reference plasmid-associated resistance, islands, insertion sequences. Finally, an overview existing, new, alternative therapies provided.

Language: Английский

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Diagnosis and management of infections caused by multidrug-resistant bacteria: guideline endorsed by the Italian Society of Infection and Tropical Diseases (SIMIT), the Italian Society of Anti-Infective Therapy (SITA), the Italian Group for Antimicrobial Stewardship (GISA), the Italian Association of Clinical Microbiologists (AMCLI) and the Italian Society of Microbiology (SIM)

International Journal of Antimicrobial Agents, Journal Year: 2022, Volume and Issue: 60(2), P. 106611 - 106611

Published: June 11, 2022

Management of patients with infections caused by multidrug-resistant organisms is challenging and requires a multidisciplinary approach to achieve successful clinical outcomes. The aim this paper provide recommendations for the diagnosis optimal management these infections, focus on targeted antibiotic therapy. document was produced panel experts nominated five endorsing Italian societies, namely Association Clinical Microbiologists (AMCLI), Group Antimicrobial Stewardship (GISA), Society Microbiology (SIM), Infectious Tropical Diseases (SIMIT) Anti-Infective Therapy (SITA). Population, Intervention, Comparison Outcomes (PICO) questions about microbiological diagnosis, pharmacological strategies therapy were addressed following pathogens: carbapenem-resistant Enterobacterales; Pseudomonas aeruginosa; Acinetobacter baumannii; methicillin-resistant Staphylococcus aureus. A systematic review literature published from January 2011 November 2020 guided PICO strategy. As data randomised controlled trials (RCTs) expected be limited, observational studies also reviewed. certainty evidence classified using GRADE approach. Recommendations as strong or conditional. Detailed formulated each pathogen. majority available RCTs have serious risk bias, many several limitations, including small sample size, retrospective design presence confounders. Thus, some are based low very-low evidence. Importantly, should continually updated reflect emerging real-world experience.

Language: Английский

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Recommendations and guidelines for the treatment of infections due to multidrug resistant organisms

Journal of Microbiology Immunology and Infection, Journal Year: 2022, Volume and Issue: 55(3), P. 359 - 386

Published: March 16, 2022

Antimicrobial drug resistance is one of the major threats to global health. It has made common infections increasingly difficult or impossible treat, and leads higher medical costs, prolonged hospital stays increased mortality. Infection rates due multidrug-resistant organisms (MDRO) are increasing globally. Active agents against MDRO limited despite an in availability novel antibiotics recent years. This guideline aims assist clinicians management MDRO. The 2019 Guidelines Recommendations for Evidence-based use Taiwan (GREAT) working group, comprising infectious disease specialists from 14 centers Taiwan, reviewed current evidences drafted recommendations treatment A nationwide expert panel during a consensus meeting Aug 2020, was endorsed by Infectious Diseases Society (IDST). includes selecting antimicrobial therapy caused carbapenem-resistant Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacterales, vancomycin-resistant Enterococcus. takes into consideration local epidemiology, that may not yet be available Taiwan. intended serve as clinical guide supersede judgment physicians individual patients.

Language: Английский

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Systematic Review of Antimicrobial Combination Options for Pandrug-Resistant Acinetobacter baumannii

Antibiotics, Journal Year: 2021, Volume and Issue: 10(11), P. 1344 - 1344

Published: Nov. 3, 2021

Antimicrobial combinations are at the moment only potential treatment option for pandrug-resistant A. baumannii. A systematic review was conducted in PubMed and Scopus studies reporting activity of antimicrobial against baumannii resistant to all components combination. The clinical relevance synergistic assessed based on concentrations achieving synergy PK/PD models. Eighty-four were retrieved including 818 eligible isolates. variety (n = 141 double, n 9 triple) tested, with a methods. Polymyxin-based most studied, either as double or triple cell-wall acting agents (including sulbactam, carbapenems, glycopeptides), rifamycins fosfomycin. Non-polymyxin predominantly rifampicin, fosfomycin, sulbactam avibactam. Several clinically relevant concentrations, while appeared more active than ones. However, no combination consistently strains tested. Notably, several reported but unlikely be relevant, concentration that observed unclear. Selecting appropriate is likely strain-specific should guided by vitro evaluation. Furthermore, there an urgent need efficacy safety such combinations.

Language: Английский

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Microbial Resistance to Antibiotics and Effective Antibiotherapy

Biomedicines, Journal Year: 2022, Volume and Issue: 10(5), P. 1121 - 1121

Published: May 12, 2022

Currently, the efficacy of antibiotics is severely affected by emergence antimicrobial resistance phenomenon, leading to increased morbidity and mortality worldwide. Multidrug-resistant pathogens are found not only in hospital settings, but also community, considered one biggest public health concerns. The main mechanisms which bacteria develop include changes drug target, prevention entering cell, elimination through efflux pumps or inactivation drugs. A better understanding prediction patterns a pathogen will lead selection active for treatment multidrug-resistant infections.

Language: Английский

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Analytical methods for the characterization and diagnosis of infection with Pseudomonas aeruginosa: A critical review

Analytica Chimica Acta, Journal Year: 2022, Volume and Issue: 1204, P. 339696 - 339696

Published: March 8, 2022

Language: Английский

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