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  • Kon, HadasIsrael Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel. (författare)

Prevalence and Clinical Consequences of Colistin Heteroresistance and Evolution into Full Resistance in Carbapenem-Resistant Acinetobacter baumannii

  • Artikel/kapitelEngelska2023

Förlag, utgivningsår, omfång ...

  • American Society for Microbiology,2023
  • electronicrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-512790
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-512790URI
  • https://doi.org/10.1128/spectrum.05093-22DOI

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  • Språk:engelska
  • Sammanfattning på:engelska

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  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • 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.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Hameir, AmichayIsrael Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel. (författare)
  • Nutman, AmirIsrael Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel.;Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel. (författare)
  • Temkin, ElizabethIsrael Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel. (författare)
  • Keren Paz, AlonaIsrael Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel. (författare)
  • Lellouche, JonathanIsrael Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel.;Ariel Univ, Adelson Sch Med, Ariel, Israel. (författare)
  • Schwartz, DavidIsrael Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel. (författare)
  • Weiss, David S.Emory Univ, Emory Antibiot Resistance Ctr, Sch Med, Atlanta, GA USA. (författare)
  • Kaye, Keith S.Rutgers State Univ, Robert Wood Johnson Med Sch, New Brunswick, NJ USA. (författare)
  • Daikos, George L.Laikon Gen Hosp, Dept Med 1, Athens, Greece.;Natl & Kapodistrian Univ Athens, Athens, Greece. (författare)
  • Skiada, AnnaLaikon Gen Hosp, Dept Med 1, Athens, Greece.;Natl & Kapodistrian Univ Athens, Athens, Greece. (författare)
  • Durante-Mangoni, EmanueleUniv Campania Luigi Vanvitelli, Dept Precis Med, Naples, Italy.;AORN Colli Monaldi Hosp, Naples, Italy. (författare)
  • Dishon Benattar, YaelInst Infect Dis, Rambam Hlth Care Campus, Haifa, Israel.;Israel Inst Technol, Ruth & Bruce Rappaport Fac Med, Techn, Haifa, Israel. (författare)
  • Yahav, DafnaTel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel.;Beilinson Med Ctr, Rabin Med Ctr, Infect Dis Unit, Petah Tiqwa, Israel. (författare)
  • Daitch, VeredTel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel.;Beilinson Med Ctr, Rabin Med Ctr, Dept Med E, Petah Tiqwa, Israel. (författare)
  • Bernardo, MarianoAORN Ospedali Colli Monaldi Hosp, Microbiol & Virol Unit, Naples, Italy. (författare)
  • Iossa, DomenicoUniv Campania Luigi Vanvitelli, Dept Precis Med, Naples, Italy. (författare)
  • Friberg, Lena E.Uppsala universitet,Institutionen för farmaci(Swepub:uu)lenasimo (författare)
  • Theuretzbacher, UrsulaCtr Antiinfect Agents, Vienna, Austria. (författare)
  • Leibovici, LeonardTel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel.;Beilinson Med Ctr, Rabin Med Ctr, Dept Med E, Petah Tiqwa, Israel. (författare)
  • Dickstein, YaakovInst Infect Dis, Rambam Hlth Care Campus, Haifa, Israel. (författare)
  • Pollak, DinaMicrobiol Lab, Rambam Hlth Care Campus, Haifa, Israel. (författare)
  • Mendelsohn, SigalMicrobiol Lab, Rambam Hlth Care Campus, Haifa, Israel. (författare)
  • Paul, MicalInst Infect Dis, Rambam Hlth Care Campus, Haifa, Israel. (författare)
  • Carmeli, YehudaIsrael Minist Hlth, Natl Inst Antibiot Resistance & Infect Control, Tel Aviv, Israel.;Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel. (författare)
  • Grp, AIDA Study (författare)
  • 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)

Sammanhörande titlar

  • Ingår i:Microbiology Spectrum: American Society for Microbiology11:32165-0497

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