PDF(Pubmed)
Abstract：
Infections due to drug-resistant Acinetobacter baumannii strains are increasing and cause significant morbidity and mortality, especially in hospitalized and critically ill patients. A. baumannii rapidly develops resistance to numerous antibiotics, and antibiotics traditionally used against this deadly pathogen have been failing in recent years, highlighting the need to identify new treatment strategies. Treatment options that have shown promise include revisiting common antibiotics not typically used against A. baumannii, evaluating new antibiotics recently introduced to market, and identifying combinations of antibiotics that display synergistic interactions. In this study, we characterized the antibiotic susceptibility profiles of extensively (XDR) and pandrug-resistant (PDR) A. baumannii patient isolates. We examined the potency of 22 standard-of-care antibiotics and the newer antibiotics eravacycline, omadacycline, and plazomicin against these strains. Furthermore, we examined combinations of these antibiotics against our collection to identify synergistic effects. We found that this collection is highly resistant to most or all standard-of-care antibiotics, except for minocycline and rifampin. We show that eravacycline and omadacycline are effective against these strains based on minimum inhibitory concentrations. We also identified two highly effective combinations, cefepime and amikacin and cefepime and ampicillin-sulbactam, which exhibited high rates of synergy against this collection. This information is valuable in our battle against highly drug resistant and virtually untreatable A. baumannii infections.
摘要：
由耐药鲍曼不动杆菌引起的感染不断增加，并导致显著的发病率和死亡率，尤其是住院和危重病人。鲍曼不动杆菌对许多抗生素迅速产生耐药性，传统上用于这种致命病原体的抗生素近年来一直在失败，强调需要确定新的治疗策略。已显示出希望的治疗选择包括重新审视通常不用于鲍曼不动杆菌的常见抗生素，评估最近上市的新抗生素，并确定显示协同相互作用的抗生素组合。在这项研究中,我们表征了广泛（XDR）和泛耐药（PDR）鲍曼不动杆菌患者分离株的抗生素敏感性。我们检查了22种标准护理抗生素和较新的抗生素埃拉环素的效力，omadacycline,和普拉佐米星对抗这些菌株。此外，我们针对我们的集合检查了这些抗生素的组合,以确定协同作用.我们发现该系列对大多数或所有标准治疗抗生素具有高度抗性，除了米诺环素和利福平.我们表明，基于最低抑制浓度，埃拉环素和奥马环素对这些菌株有效。我们还确定了两种高效的组合，头孢吡肟和阿米卡星，头孢吡肟和氨苄西林-舒巴坦，对这个集合表现出很高的协同作用。这些信息在我们对抗高度耐药和几乎无法治愈的鲍曼不动杆菌感染的斗争中很有价值。
