The Multifaceted Landscape of Healthcare-Associated Infections Caused by Carbapenem-Resistant Acinetobacter baumannii DOI Creative Commons
Alessandro Russo, Francesca Serapide

Microorganisms, Journal Year: 2025, Volume and Issue: 13(4), P. 829 - 829

Published: April 5, 2025

Carbapenem-resistant Acinetobacter baumannii (CRAB) is an emerging and important major cause of nosocomial infections, posing a significant challenge to clinicians worldwide. The intrinsic acquired resistance mechanisms exhibited by CRAB, associated with its ability persist in healthcare environments, have transformed it into critical public health concern. clinical implications CRAB infections include severe manifestations, like ventilator-associated pneumonia bloodstream infections. These are often increased morbidity mortality, particularly critically ill patients, such as those intensive care units, immunocompromised, undergoing invasive procedures. Considering these characteristics, the therapeutic armamentarium for treatment increasingly limited, strains exhibit broad range antibiotics, including carbapenems new β-lactam inhibitors, which considered last-line agents many bacterial An role represented cefiderocol data from real-world evidence. aim this narrative review discuss main topics infection strategies prevention, management, therapy.

Language: Английский

Antibiotic Treatment of Carbapenem-Resistant Acinetobacter baumannii Infections in View of the Newly Developed β-Lactams: A Narrative Review of the Existing Evidence DOI Creative Commons
Francesca Serapide,

Maurizio Guastalegname,

Sara Palma Gullì

et al.

Antibiotics, Journal Year: 2024, Volume and Issue: 13(6), P. 506 - 506

Published: May 29, 2024

It is estimated that antimicrobial resistance (AMR) responsible for nearly 5 million human deaths worldwide each year and will reach 10 by 2050. Carbapenem-resistant Acinetobacter baumannii (CRAB) infections represent the fourth-leading cause of death attributable to globally, but a standardized therapy still lacking. Among antibiotics under consideration, Sulbactam/durlobactam seems be best candidate replace current back-bone agents. Cefiderocol could play pivotal role within combination regimens. Due toxicity pharmacokinetics/pharmacodynamics (PK/PD) limitations, colistin (or polymyxin B) should used as an alternative agent (when no other options are available). Tigecycline minocycline) fosfomycin suitable partners both NBLs. Randomized clinical trials (RCTs) needed better evaluate NBLs in CRAB infection treatment compare efficacy tigecycline partner antibiotics. Synergism tested between “old” drugs (rifampicin trimethoprim/sulfamethoxazole). Huge efforts made accelerate pre-clinical studies on safer candidates with improved lung activity, well iv rifabutin formulation. In this narrative review, we focused antibiotic view newly developed β-lactam agents (NBLs).

Language: Английский

Citations

12
Real-World Use, Effectiveness, and Safety of Intravenous Fosfomycin: The FORTRESS Study DOI Creative Commons

Klaus‐Friedrich Bodmann,

Stefan Hagel, Alessandra Oliva

et al.

Infectious Diseases and Therapy, Journal Year: 2025, Volume and Issue: unknown

Published: March 19, 2025

Intravenous fosfomycin (FOS) is a broad-spectrum antibiotic primarily used in combination therapy to treat severe infections caused by both Gram-positive (GP) and Gram-negative (GN) pathogens, including multi-drug resistant (MDR) bacteria. The aim of this study, the largest date, was evaluate effectiveness, safety, usage patterns, patient characteristics FOS real-world setting. Interim analysis an ongoing, prospective, non-interventional, multicentre study five European countries, involving centres Germany, Italy, United Kingdom, Greece, Austria. A total 716 patients were enrolled between January 2017 November 2023 (mean age: 62.8 years, APACHE II: 18.3, SOFA: 6.7). Main indications for bacteraemia/sepsis (23.6%), complicated urinary tract (18.0%), bone joint (17.4%). Other included hospital-acquired/ventilator-associated pneumonia (11.0%), skin soft tissue (9.1%), bacterial meningitis/central nervous system (CNS) (7.8%), infective endocarditis (6.4%). Most common pathogens identified Staphylococcus aureus (31.4%, methicillin-resistant S. aureus), Klebsiella spp. (including K. pneumoniae) (17.2%), Escherichia coli (14.2%), coagulase-negative staphylococci (12.9%), other Enterobacterales (10.9%), Pseudomonas aeruginosa (8.4%). In 34.6% patients, MDR pathogen involved. Carbapenem resistance (CR) high (59/123, 48.0%). most (90.2%). median dose 15 g/day. Overall, clinical success response favourable with 75.3% 83.4% at end treatment. Clinical rates or CR 78.0% 81.8%, respectively. Microbiological cure achieved 82.4% all patients. Electrolyte imbalances frequently observed adverse drug reactions, while gastrointestinal disorders rare. results from suggest that safe effective option as partner treatment GP GN deep-seated and/or involvement ClinicalTrials.gov identifier, NCT02979951.

Language: Английский

Citations

1
Antibiotic Treatment of Carbapenem-Resistant <em>Acinetobacter baumannii </em>Infections in View of the Newly Developed β-Lactams: A Narrative Review of the Existing Evidence DOI Open Access
Francesca Serapide,

Maurizio Guastalegname,

Sara Palma Gullì

et al.

Published: May 6, 2024

Carbapenem-resistant Acinetobacter baumannii (CRAB) infections represent the fourth-leading cause of death attributable to antimicrobial resistance globally, but a standardized therapy is still lacking. In this narrative review we focused antibiotic treatment CRAB in view newly β-lactam agents (NBLs) like sulbactam/durlobactam and cefiderocol, discussing main hot points such as superiority combination over monotherapy best partner use combination. Sulbactam/durlobactam seems be candi-date replace current back-bone agents. Cefiderocol, could play crucial role combina-tion-regimen. Due toxicity PK/PD limitations, colistin (or polymyxin B) should used an alternative agent (when no other options are available). Tigecycline minocycline) fosfomycin suitable partners for both NBLs. Randomized clinical trials (RCTs) needed better evaluate NBLs infection compare ef-ficacy tigecycline antibiotics. Synergism tested between “old” drugs (rifampicin trimethoprim/sulfamethoxazole). Huge efforts made accelerate pre-clinical studies on safer candidates with lung im-proved activity, well i.v. rifabutin formulation.

Language: Английский

Citations

6
From Clinical Trials to Real-World Experiences: Evidence About Cefiderocol Use and Potential Role in Empirical Therapy DOI Creative Commons
Alessandro Russo, Francesca Serapide

Infectious Diseases and Therapy, Journal Year: 2025, Volume and Issue: unknown

Published: April 9, 2025

Cefiderocol is a novel siderophore cephalosporin that has gained attention for its potent activity against multidrug-resistant (MDR) Gram-negative pathogens, making it valuable addition to the antimicrobial armamentarium. Its efficacy in treating complicated urinary tract infections (cUTIs) and nosocomial pneumonia been well-established, although challenges remain regarding role Acinetobacter baumannii possible emergence of resistance. The decision use cefiderocol as monotherapy or combination should be guided by pathogen susceptibility, clinical severity, local epidemiology. Then, potential serve an effective empirical therapy, careful stewardship, further research are essential maximize therapeutic benefits ensure long-term efficacy. This review explores cefiderocol, resistance development, heteroresistance, treatment regimens. We discuss data about trials real-world evidence assess future antibiotic

Language: Английский

Citations

0
Emerging Concepts for the Treatment of Biofilm-Associated Bone and Joint Infections with IV Fosfomycin: A Literature Review DOI Creative Commons
Sara Tedeschi, Efthymia Giannitsioti, Christian Mayer

et al.

Microorganisms, Journal Year: 2025, Volume and Issue: 13(5), P. 963 - 963

Published: April 23, 2025

Due to the involvement of biofilms in pathogenesis bone and joint infections (BJI), treatment these is often challenging, especially when multidrug- or extensively drug-resistant (MDR/XDR) pathogens are involved. Intravenous fosfomycin (FOS) a phosphoenolpyruvate analogue with unique mode action broad-spectrum activity against both Gram-positive (GP) Gram-negative (GN) pathogens. It used various severe deep-seated infections, including BJIs. This review article focuses on preclinical clinical data surrounding use FOS for biofilm-related Data from several vitro animal models infection demonstrated that FOS, combination other antibiotics, effective (methicillin-resistant) Staphylococcus spp., (vancomycin-resistant) Enterococcus carbapenem-resistant extended-spectrum beta-lactamase-producing Enterobacterales, MDR Pseudomonas aeruginosa. studies, mostly retrospective observational studies case reports/case series, revealed was typically antibiotics BJI, acute chronic osteomyelitis, prosthetic fracture-related adult pediatric patients. Success rates exceeded 80%. exhibits good fast penetration into tissue generally well tolerated, only few adverse drug reactions, such as gastrointestinal disorders electrolyte imbalances. Collectively, indicate valuable option part regimens BJIs caused by GP GN bacteria.

Language: Английский

Citations

0
Risk factors for the development of hospital-acquired pneumonia in patients with carbapenem-resistant Acinetobacter baumannii respiratory colonization and the role of multisite colonization: a multicenter retrospective study DOI Creative Commons
Alessandro Russo, Francesca Serapide, Francesco Alessandri

et al.

European Journal of Clinical Microbiology & Infectious Diseases, Journal Year: 2025, Volume and Issue: unknown

Published: April 28, 2025

Language: Английский

Citations

0
Risk factors for infection after carbapenem-resistant Acinetobacter baumannii colonization DOI Creative Commons
Maddalena Peghin,

Filippo Givone,

Maria De Martino

et al.

European Journal of Clinical Microbiology & Infectious Diseases, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 16, 2024

Abstract Purpose Predicting infection risk in carbapenem-resistant Acinetobacter baumannii (CRAB) colonized patients may help improving timely appropriate antibiotic therapy. This study aims to explore factors for developing infections hospitalized with previous CRAB colonization. Methods We performed an observational retrospective cohort at ASST Sette Laghi-Varese Hospital between January 2020 and December 2022. All consecutive adult (> 18 years old) documented colonization by any anatomical site or preceded were included. Univariate multivariate analyses investigate factors. Results Overall, 144 included the study: 104 only 40 infected patients. Colonization rates significantly changed over (2020–2022, p < 0.001). The incidence of carriers was 27.8% (40/144). Median time from 4 days (IQR 1-8.5). inhospital mortality 32.7% 55.0% patients, respectively. At multivariable logistic regression cardiovascular disease (OR 5.83, 95% CI 1.12–30.43, = 0.037), COVID-19 3.72, 1.16–11.91, 0.027) intensive care unit (ICU) admission 8.83, 2.94–26.51, 0.001) independently associated after Conclusions observed increased disease, admitted ICU setting. Additional evidence is needed identify predictors

Language: Английский

Citations

3
Are cefiderocol or sulbactam/durlobactam better than alternative best available treatment for infection by carbapenem-resistant A. baumannii? A systematic literature review DOI Creative Commons
Stamatis Karakonstantis, Πέτρος Ιωάννου, Diamantis P. Kofteridis

et al.

Infection, Journal Year: 2025, Volume and Issue: unknown

Published: April 7, 2025

Language: Английский

Citations

0
The Multifaceted Landscape of Healthcare-Associated Infections Caused by Carbapenem-Resistant Acinetobacter baumannii DOI Creative Commons
Alessandro Russo, Francesca Serapide

Microorganisms, Journal Year: 2025, Volume and Issue: 13(4), P. 829 - 829

Published: April 5, 2025

Carbapenem-resistant Acinetobacter baumannii (CRAB) is an emerging and important major cause of nosocomial infections, posing a significant challenge to clinicians worldwide. The intrinsic acquired resistance mechanisms exhibited by CRAB, associated with its ability persist in healthcare environments, have transformed it into critical public health concern. clinical implications CRAB infections include severe manifestations, like ventilator-associated pneumonia bloodstream infections. These are often increased morbidity mortality, particularly critically ill patients, such as those intensive care units, immunocompromised, undergoing invasive procedures. Considering these characteristics, the therapeutic armamentarium for treatment increasingly limited, strains exhibit broad range antibiotics, including carbapenems new β-lactam inhibitors, which considered last-line agents many bacterial An role represented cefiderocol data from real-world evidence. aim this narrative review discuss main topics infection strategies prevention, management, therapy.

Language: Английский

Citations

0