Akademik Veri Yönetim Sistemi
28. ECCMID, Madrid, İspanya, 21 - 24 Nisan 2018, ss.1116-1117
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.