Detection of colistin heteroresistance in Acinetobacter baumannii from blood and respiratory isolates

Diagnostic Microbiology and Infectious Disease
Pavithra SrinivasKarri A Bauer

Abstract

Polymyxins are one of the last-line antibiotics for multidrug-resistant Acinetobacter baumannii. Reports have demonstrated the emergence of colistin heteroresistance in A. baumannii, which can complicate assessment of minimum inhibitory concentrations and promote resistance to colistin. We aimed to determine the presence of colistin heteroresistance in A. baumannii isolates and correlate the results with clinical and microbiological outcomes via a retrospective study of 24 adult patients: 12 blood and 12 invasive respiratory cultures positive for colistin-susceptible A. baumannii between 1 January 2013 and 31 July 2015. Heteroresistance testing was performed by plating a 100-μL bacterial cell suspension on Mueller-Hinton agar plates containing 0, 1, 2, and 4 μg/mL colistin, and assessing for growth at 24 and 48 h. Colistin heteroresistance was exhibited in 83% of isolates. Median age was 56 [43-65] years, 10 (42%) patients resided at a facility prior to admission, 5 (21%) had a chronic tracheostomy, 18 (75%) were in the intensive care unit at the time of culture collection, and median infection-related length of stay was 12 [7-15] days. Clinical and microbiological cures were achieved in 75% of patients. Overall infection-relat...Continue Reading

Citations

May 10, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Cristina Vazquez Guillamet, Marin H Kollef
Dec 7, 2018·Current Opinion in Infectious Diseases·José Garnacho-Montero, Jean-François Timsit
Jun 27, 2019·Nature Reviews. Microbiology·Dan I AnderssonKarin Hjort
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