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Prevalence and Clin...
Prevalence and Clinical Consequences of Colistin Heteroresistance and Evolution into Full Resistance in Carbapenem-Resistant Acinetobacter baumannii
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- Kon, Hadas (author)
- Israel Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel.
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- Hameir, Amichay (author)
- Israel Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel.
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- Nutman, Amir (author)
- Israel Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel.;Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel.
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- Temkin, Elizabeth (author)
- Israel Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel.
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- Keren Paz, Alona (author)
- Israel Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel.
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- Lellouche, Jonathan (author)
- Israel Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel.;Ariel Univ, Adelson Sch Med, Ariel, Israel.
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- Schwartz, David (author)
- Israel Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel.
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- Weiss, David S. (author)
- Emory Univ, Emory Antibiot Resistance Ctr, Sch Med, Atlanta, GA USA.
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- Kaye, Keith S. (author)
- Rutgers State Univ, Robert Wood Johnson Med Sch, New Brunswick, NJ USA.
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- Daikos, George L. (author)
- Laikon Gen Hosp, Dept Med 1, Athens, Greece.;Natl & Kapodistrian Univ Athens, Athens, Greece.
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- Skiada, Anna (author)
- Laikon Gen Hosp, Dept Med 1, Athens, Greece.;Natl & Kapodistrian Univ Athens, Athens, Greece.
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- Durante-Mangoni, Emanuele (author)
- Univ Campania Luigi Vanvitelli, Dept Precis Med, Naples, Italy.;AORN Colli Monaldi Hosp, Naples, Italy.
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- Dishon Benattar, Yael (author)
- Inst Infect Dis, Rambam Hlth Care Campus, Haifa, Israel.;Israel Inst Technol, Ruth & Bruce Rappaport Fac Med, Techn, Haifa, Israel.
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- Yahav, Dafna (author)
- Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel.;Beilinson Med Ctr, Rabin Med Ctr, Infect Dis Unit, Petah Tiqwa, Israel.
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- Daitch, Vered (author)
- Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel.;Beilinson Med Ctr, Rabin Med Ctr, Dept Med E, Petah Tiqwa, Israel.
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- Bernardo, Mariano (author)
- AORN Ospedali Colli Monaldi Hosp, Microbiol & Virol Unit, Naples, Italy.
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- Iossa, Domenico (author)
- Univ Campania Luigi Vanvitelli, Dept Precis Med, Naples, Italy.
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- Friberg, Lena E. (author)
- Uppsala universitet,Institutionen för farmaci
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- Theuretzbacher, Ursula (author)
- Ctr Antiinfect Agents, Vienna, Austria.
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- Leibovici, Leonard (author)
- Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel.;Beilinson Med Ctr, Rabin Med Ctr, Dept Med E, Petah Tiqwa, Israel.
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- Dickstein, Yaakov (author)
- Inst Infect Dis, Rambam Hlth Care Campus, Haifa, Israel.
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- Pollak, Dina (author)
- Microbiol Lab, Rambam Hlth Care Campus, Haifa, Israel.
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- Mendelsohn, Sigal (author)
- Microbiol Lab, Rambam Hlth Care Campus, Haifa, Israel.
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- Paul, Mical (author)
- Inst Infect Dis, Rambam Hlth Care Campus, Haifa, Israel.
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- Carmeli, Yehuda (author)
- Israel Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel.;Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel.
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Grp, AIDA Study (author)
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Israel Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel Israel Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel.;Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel. (creator_code:org_t)
- American Society for Microbiology, 2023
- 2023
- English.
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In: Microbiology Spectrum. - : American Society for Microbiology. - 2165-0497. ; 11:3
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Abstract
Subject headings
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- Colistin heteroresistance (HR) refers to a bacterial population comprised of several subpopulations with different levels of resistance to colistin. In this study, we discuss the classic form of HR, in which a resistant subpopulation exists within a predominantly susceptible population. We investigated the prevalence of colistin HR and its evolution into full resistance among 173 clinical carbapenem-resistant Acinetobacter baumannii isolates and examined the effect of HR on clinical outcomes. To determine HR, we performed population analysis profiling. Our results showed a high prevalence of HR (67.1%). To examine evolution of HR strains into full resistance, the HR strains were grown in colistin-containing broth, transferred onto colistin-containing plates, and colonies on these plates were transferred into colistin-free broth. Many of the HR strains (80.2%) evolved into full resistance, 17.2% reverted to HR, and 2.6% were borderline. We used logistic regression to compare 14-day clinical failure and 14-day mortality between patients infected by HR versus susceptible non-HR carbapenem-resistant A. baumannii. In the subgroup of patients with bacteremia, HR was significantly associated with 14-day mortality.IMPORTANCE To our knowledge, this is the first large-scale study to report on HR in Gram-negative bacteria. We described the prevalence of colistin HR in a large sample of carbapenem-resistant A. baumannii isolates, the evolution of many colistin HR isolates to a resistant phenotype following colistin exposure and withdrawal, and the clinical consequences of colistin HR. We found a high prevalence of HR among clinical carbapenem-resistant A. baumannii isolates; most evolved into a resistant phenotype following colistin exposure and withdrawal. In patients treated with colistin, evolution of HR A. baumannii into full resistance could lead to higher rates of treatment failure and contribute to the reservoir of colistin-resistant pathogens in health care settings. To our knowledge, this is the first large-scale study to report on HR in Gram-negative bacteria. We described the prevalence of colistin HR in a large sample of carbapenem-resistant A. baumannii isolates, the evolution of many colistin HR isolates to a resistant phenotype following colistin exposure and withdrawal, and the clinical consequences of colistin HR.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Mikrobiologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Microbiology in the medical area (hsv//eng)
Keyword
- Acinetobacter baumannii
- carbapenem-resistance
- colistin
- heteroresistance
- population analysis profiling
Publication and Content Type
- ref (subject category)
- art (subject category)
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Kon, Hadas
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Hameir, Amichay
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Nutman, Amir
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Temkin, Elizabet ...
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Keren Paz, Alona
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Lellouche, Jonat ...
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Schwartz, David
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Weiss, David S.
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Kaye, Keith S.
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Daikos, George L ...
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Skiada, Anna
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Durante-Mangoni, ...
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Dishon Benattar, ...
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Yahav, Dafna
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Daitch, Vered
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Bernardo, Marian ...
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Iossa, Domenico
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Friberg, Lena E.
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Theuretzbacher, ...
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Leibovici, Leona ...
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Dickstein, Yaako ...
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Pollak, Dina
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Mendelsohn, Siga ...
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Paul, Mical
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Carmeli, Yehuda
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Grp, AIDA Study
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