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Outcomes in Patients Infected with Carbapenem-resistant Acinetobacter Baumannii and Treated with Tigecycline Alone or in Combination Therapy

Overview
Journal Infection
Date 2011 Jul 27
PMID 21789524
Citations 17
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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.

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References
1.
Ricciardi R, Ricciardi A, Danzi G . In vitro activity of tigecycline against multidrug-resistant Acinetobacter baumannii clinical isolates. Infez Med. 2010; 17(4):236-9. View

2.
Gordon N, Wareham D . A review of clinical and microbiological outcomes following treatment of infections involving multidrug-resistant Acinetobacter baumannii with tigecycline. J Antimicrob Chemother. 2009; 63(4):775-80. DOI: 10.1093/jac/dkn555. View

3.
Poulakou G, Kontopidou F, Paramythiotou E, Kompoti M, Katsiari M, Mainas E . Tigecycline in the treatment of infections from multi-drug resistant gram-negative pathogens. J Infect. 2009; 58(4):273-84. DOI: 10.1016/j.jinf.2009.02.009. View

4.
Garcia-Garmendia J, Ortiz-Leyba C, Garnacho-Montero J, Jimenez-Jimenez F, Monterrubio-Villar J, Gili-Miner M . Mortality and the increase in length of stay attributable to the acquisition of Acinetobacter in critically ill patients. Crit Care Med. 1999; 27(9):1794-9. DOI: 10.1097/00003246-199909000-00015. View

5.
Garner J, Jarvis W, Emori T, Horan T, Hughes J . CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988; 16(3):128-40. DOI: 10.1016/0196-6553(88)90053-3. View