Secular trends in Acinetobacter baumannii resistance in respiratory and blood stream specimens in the United States, 2003 to 2012: A survey study.

MedStar author(s):
Citation: Journal of Hospital Medicine (Online). 11(1):21-6, 2016 Jan.PMID: 26353076Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, Non-U.S. Gov'tSubject headings: *Acinetobacter baumannii/de [Drug Effects] | *Acinetobacter Infections/dt [Drug Therapy] | *Anti-Bacterial Agents/tu [Therapeutic Use] | *Bacteremia/dt [Drug Therapy] | *Drug Resistance, Bacterial | *Respiratory Tract Infections/dt [Drug Therapy] | Acinetobacter baumannii/ip [Isolation & Purification] | Acinetobacter Infections/mi [Microbiology] | Ampicillin/tu [Therapeutic Use] | Anti-Bacterial Agents/pd [Pharmacology] | Carbapenems/tu [Therapeutic Use] | Cross Infection | Humans | Intensive Care Units | Microbial Sensitivity Tests/mt [Methods] | Sulbactam/tu [Therapeutic Use] | Surveys and Questionnaires | Trimethoprim, Sulfamethoxazole Drug Combination/tu [Therapeutic Use] | United StatesYear: 2016Local holdings: Available in print through MWHC library: 2007 onlyISSN:
  • 1553-5592
Name of journal: Journal of hospital medicineAbstract: BACKGROUND: Acinetobacter baumannii (AB) has evolved a variety of resistance mechanisms and exhibits unpredictable susceptibility patterns, making it difficult to select empiric therapy.CONCLUSIONS: Resistance rates among AB to such last-resort antimicrobials as carbapenems and colistin are on the rise, whereas that to minocycline has declined. Nursing homes are a reservoir of resistant AB. These trends should inform not only empiric treatment of serious infections, but also approaches to infection control.Copyright © 2015 Society of Hospital Medicine.DESIGN: Survey.METHODS: We analyzed 3 time periods (2003-2005, 2006-2008, 2009-2012) in Eurofins' The Surveillance Network for resistance of AB to the following antimicrobials: carbapenems (imipenem, meropenem, doripenem), aminoglycosides (tobramycin, amikacin), tetracyclines (minocycline, doxycycline), polymyxins (colistin, polymyxin B), ampicillin-sulbactam, and trimethoprim-sulfamethoxazole. Resistance to >3 drug classes defined multidrug resistance (MDR).OBJECTIVE: To examine US secular trends in the resistance of AB in respiratory infections and blood stream infections (BSI) to antimicrobial agents whose effectiveness is supported in the literatureRESULTS: We identified 39,320 AB specimens (81.1% respiratory, 18.9% BSI). The highest prevalence of resistance was to doripenem (90.3%) followed by trimethoprim-sulfamethoxazole (55.3%), and the lowest to colistin (5.3%). Resistance to carbapenems (21.0% in 2003-2005 and 47.9% in 2009-2012) and colistin (2.8% in 2006-2008 to 6.9% in 2009-2012) more than doubled. Prevalence of MDR AB rose from 21.4% in 2003 to 2005 to 33.7% in 2006 to 2008, and remained stable at 35.2% in 2009 to 2012. In contrast, resistance to minocycline diminished from 56.5% (2003-2005) to 30.5% (2009-2012). MDR organisms were most frequent in nursing homes (46.5%), followed by general ward (29.2%), intensive care unit (28.7%), and outpatient setting (26.2%).All authors: Kollef MH, Shorr AF, Zilberberg MDFiscal year: FY2016Digital Object Identifier: Date added to catalog: 2016-09-07
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 26353076 Available 26353076

Available in print through MWHC library: 2007 only

BACKGROUND: Acinetobacter baumannii (AB) has evolved a variety of resistance mechanisms and exhibits unpredictable susceptibility patterns, making it difficult to select empiric therapy.

CONCLUSIONS: Resistance rates among AB to such last-resort antimicrobials as carbapenems and colistin are on the rise, whereas that to minocycline has declined. Nursing homes are a reservoir of resistant AB. These trends should inform not only empiric treatment of serious infections, but also approaches to infection control.Copyright © 2015 Society of Hospital Medicine.

DESIGN: Survey.

METHODS: We analyzed 3 time periods (2003-2005, 2006-2008, 2009-2012) in Eurofins' The Surveillance Network for resistance of AB to the following antimicrobials: carbapenems (imipenem, meropenem, doripenem), aminoglycosides (tobramycin, amikacin), tetracyclines (minocycline, doxycycline), polymyxins (colistin, polymyxin B), ampicillin-sulbactam, and trimethoprim-sulfamethoxazole. Resistance to >3 drug classes defined multidrug resistance (MDR).

OBJECTIVE: To examine US secular trends in the resistance of AB in respiratory infections and blood stream infections (BSI) to antimicrobial agents whose effectiveness is supported in the literature

RESULTS: We identified 39,320 AB specimens (81.1% respiratory, 18.9% BSI). The highest prevalence of resistance was to doripenem (90.3%) followed by trimethoprim-sulfamethoxazole (55.3%), and the lowest to colistin (5.3%). Resistance to carbapenems (21.0% in 2003-2005 and 47.9% in 2009-2012) and colistin (2.8% in 2006-2008 to 6.9% in 2009-2012) more than doubled. Prevalence of MDR AB rose from 21.4% in 2003 to 2005 to 33.7% in 2006 to 2008, and remained stable at 35.2% in 2009 to 2012. In contrast, resistance to minocycline diminished from 56.5% (2003-2005) to 30.5% (2009-2012). MDR organisms were most frequent in nursing homes (46.5%), followed by general ward (29.2%), intensive care unit (28.7%), and outpatient setting (26.2%).

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