Jun 29, 2010

Multiresistant Acinetobacter baumannii infections: epidemiology and management

Current Opinion in Infectious Diseases
José Garnacho-Montero, Rosario Amaya-Villar

Abstract

We present recent data about epidemiology of Acinetobacter baumannii in the hospital setting, major resistance mechanisms, and therapeutic options for infections caused by multidrug-resistant strains. A. baumannii has emerged as a major cause of healthcare-associated infections. It commonly presents resistance to multiple antimicrobial agents, including carbapenems. These strains are now ussually resistant to the rest of antipseudomonal beta-lactams and sulbactam, a beta-lactamase inhibitor with bactericide activity against A. baumannii. Rifampicin has demonstrated its effectiveness in animal models but can never be used in monotherapy because of the rapid development of resistance. Colistin, an old antibiotic, has re-emerged as a valid alternative given its excellent in-vitro activity. Numerous studies have confirmed its efficacy in serious infections, including ventilator-associated pneumonia and nosocomial meningitis, with an acceptable safety profile. Tigecycline appears as a promising therapeutic option for multidrug resistant A. baumannii, althogh more clinical data about its efficacy especially in pulmonary infections are required. The role of combination therapy or the use or colistin in alternative routes (nebulized or...Continue Reading

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References

Mentioned in this Paper

Sulbactam
Acinetobacter calcoaceticus
Bactericide, NOS
beta-Lactams
Carbapenems
Infectious Disease of Lung
Colistin
Amorphophallus baumannii
Beta Lactamase Inhibitor [EPC]
Etiology

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