Successful treatment of skin and soft tissue infection due to carbapenem-resistant Acinetobacter baumannii by ampicillin-sulbactam and meropenem combination therapy.

Abstract

In recent years, carbapenem-resistant Acinetobacter baumannii infections have been responsible for outbreaks in medical facilities. A 35-year-old Japanese woman developed a skin and soft tissue infection due to carbapenem-resistant A. baumannii. The isolate was resistant to antibiotics other than ampicillin-sulbactam and colistin, suggesting drug resistance due to carbapenemase production by OXA-23. We selected a combination therapy consisting of intravenous ampicillin-sulbactam and meropenem. No changes were observed in aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, or serum creatinine during therapy, and carbapenem-resistant A. baumannii was not detected in wound exudates 3 days after therapy initiation. In our patient's case, combination therapy with ampicillin-sulbactam and meropenem was successful. Thus, combination therapy with ampicillin-sulbactam and meropenem is effective against skin and soft tissue infection due to carbapenem-resistant A. baumannii. Combination therapy with intravenous ampicillin-sulbactam and meropenem may be an option for skin and soft tissue infections due to carbapenem-resistant A. baumannii.

• Authors: Yoichi Hiraki, Mayumi Yoshida, Yoko Masuda, Daisuke Inoue, Yasuhiro Tsuji, Hidetoshi Kamimura, Yoshiharu Karube, Kazutaka Takaki, Fumio Kawano
• Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (Int J Infect Dis) Vol. 17 Issue 12 Pg. e1234-6 (Dec 2013) ISSN: 1878-3511 [Electronic] Canada
• PMID: 23791858 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Carbapenems
• Thienamycins
• sultamicillin
• Ampicillin
• Meropenem
• Sulbactam

Topics

• Acinetobacter Infections (diagnosis, drug therapy)
• Acinetobacter baumannii (drug effects, isolation & purification)
• Adult
• Ampicillin (pharmacology, therapeutic use)
• Anti-Bacterial Agents (pharmacology, therapeutic use)
• Carbapenems (pharmacology)
• Drug Therapy, Combination
• Female
• Humans
• Meropenem
• Microbial Sensitivity Tests
• Skin Diseases, Bacterial (diagnosis, drug therapy)
• Soft Tissue Infections (diagnosis, drug therapy, microbiology)
• Sulbactam (pharmacology, therapeutic use)
• Thienamycins (pharmacology, therapeutic use)
• Treatment Outcome
• beta-Lactam Resistance