Evolution of multidrug-resistant Acinetobacter baumannii pneumonia in years in terms of tigecycline treatment


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Önal U. , Uyan A., Akyol D., Guliyeva G., Yamazhan T., Pullukçu H., ...More

28. ECCMID, Madrid, Spain, 21 - 24 April 2018, pp.1116-1117

  • Publication Type: Conference Paper / Summary Text
  • City: Madrid
  • Country: Spain
  • Page Numbers: pp.1116-1117

Abstract

Background: The aim of this study was to evaluate and compare the efficacy and susceptibility patterns of tigecyline in MDR A. baumannii pneumonia in a recent vs retrospective cohort. Materials/methods: This study was performed at a tertiary-care educational university hospital. The outcome of adult (>18 years old) patients who were consulted by Infectious Diseases consultants due to culture proven MDR A. baumannii pneumonia and treated with tigecycline between March 2016 and October 2017 (Group B) was compared with a similar retrospective cohort from our center (Group A, published in J Chemother. 2011 Dec;23(6):345-9). HAP and VAP were defined according to American Thoracic Society Guidelines. Identification of A. baumannii and determination of antimicrobial susceptibility were performed using the VITEK 2 automated system (BioMerieux Inc, Mercy L'etoil, France) and conventional methods. For tigecycline susceptibility, the FDA clinical minimum inhibitory concentration (MIC) breakpoints for Enterobacteriaceae ( 2 mg/l--sensitive) were used. Cefoperazone/sulbactam (C/S) susceptibility was analyzed via the disc diffusion test; CLSI criteria for susceptibility breakpoints for cefoperazone were used. Statistical analysis was performed via Chi square test and a p value less than 0.05 was considered significant. Results: There were a total of 90 cases of pneumonia due to MDR A.baumannii (72 patients in Group A and 18 patients in Group B). A total number of 47 and 10 cases were considered as ventilatorassociated pneumonia in group A and B, respectively. Tigecycline and C/S susceptibility were significantly less in group B (Table 1). Microbiologic eradication (on day 3 and 7) was observed in 47 cases (65.2%) versus 10 cases (55.5%) in group A and B, respectively. C/S combination was significantly more common in group A while colistin combination was more comon in group B. Overall one-month survival rates in group A, group B, tigecycline monotherapy (group A+B), tigecycline+any combination (group A+B) were 46% (32/72), 56% (10/18), 52% (13/25) and 52% (34/65), respectively (Table 1, p>0.05). Conclusions: Our findings show that tigecycline resistance rates in A. baumannii increased during years. Although eradication rates were not very low, mortality rates were still high in this group of patients.