Outcomes in patients infected with carbapenem-resistant Acinetobacter baumannii and treated with tigecycline alone or in combination therapy.

Abstract

PURPOSE:

Acinetobacter baumannii is a non-fermenting aerobic gram-negative bacteria and one of the important nosocomial pathogens, especially in intensive care units (ICUs). In recent years, multidrug-resistant (MDR) isolates have been an emerging problem, with limited therapeutic options. Tigecycline is a novel antimicrobial, with its in vitro activity against most gram-positive and gram-negative pathogens.

METHODS:

This is a retrospective study that was conducted in a tertiary care hospital with 550 beds in Ankara, Turkey, from January 2009 to July 2010. Thirty-three patients who had carbapenem-resistant Acinetobacter spp. infections and received tigecycline alone or in combination with other antibiotics for at least 3 days were included.

RESULTS:

The median age of the patients was 62 (18-87) years. All of the patients were diagnosed and treated in the ICU. Clinical responses were observed in 23 patients (69.7%). Ten patients (30%) had clinical failure. There was no significant difference between ventilator-associated pneumonia (VAP) and bloodstream infection (BSI) in terms of clinical or microbiological outcome (p > 0.05). The microbiological response rate was 50%. Superinfection was detected in 13 patients (43.3%) and Pseudomonas aeruginosa was the most frequently isolated pathogen. The 30-day overall mortality rate and attributable mortality rates were 57.6 and 24.2%, respectively. The attributable mortality rate was higher in the group in which microbiological eradication was not provided.

CONCLUSIONS:

Although it is approved by the Food and Drug Administration (FDA) for the treatment of complicated intra-abdominal infections, complicated skin and soft tissue infections, and community-acquired bacterial pneumonia, emerged resistance of Acinetobacter spp. and limited therapeutic options left physicians no choice but to use tigecycline for off-label indications.

• Authors: R Guner, I Hasanoglu, S Keske, A K Kalem, M A Tasyaran
• Journal: Infection (Infection) Vol. 39 Issue 6 Pg. 515-8 (Dec 2011) ISSN: 1439-0973 [Electronic] Germany
• PMID: 21789524 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Carbapenems
• Tigecycline
• Minocycline

Topics

• Acinetobacter Infections (drug therapy, microbiology)
• Acinetobacter baumannii (drug effects, isolation & purification)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents (administration & dosage, pharmacology)
• Carbapenems (pharmacology)
• Drug Therapy, Combination (methods)
• Drug Utilization (statistics & numerical data)
• Female
• Hospitals
• Humans
• Male
• Middle Aged
• Minocycline (administration & dosage, analogs & derivatives, pharmacology)
• Retrospective Studies
• Tigecycline
• Treatment Outcome
• Turkey
• Young Adult
• beta-Lactam Resistance