Growing OXA-23 type strains among carbapenem-resistant Acinetobacter baumannii and tigecycline as an alternate combination therapy

Turk J Med Sci. 2016 Dec 20;46(6):1894-1899. doi: 10.3906/sag-1508-20.

Abstract

Background/aim: The increasing prevalence and global spread of difficult-to-treat carbapenem-resistant Acinetobacter baumannii has become a serious problem. The aim of this study is to investigate the resistance patterns and tigecycline sensitivity of carbapenem-resistant A. baumannii strains.

Materials and methods: Acinetobacter strains that were carbapenem-resistant and collected mainly from intensive care units were included into this study. The antibiotic sensitivity/resistance of the strains to other antibiotics and tigecycline were noted. Presence of blaOXA-23, blaOXA-48, blaOXA-58, and NDM-1 was investigated by PCR.

Results: In total, 44 carbapenem-resistant A. baumannii strains were detected. In addition, 57% (25/44) showed resistance to netilmicin and 2% (1/43) to tigecycline. All of the strains were susceptible to colistin. blaOXA-58 was found only in one (2%) strain while blaOXA-23 was found in 14 (32%) strains. All strains were negative for blaOXA-48 and NDM-1.

Conclusion: blaOXA-23 was the main resistance pattern in carbapenem-resistant A. baumannii strains. blaOXA-58 was present only in one strain and no blaOXA-48 was found. Tigecycline susceptibility is high and it can be a treatment option for a possible combination therapy of carbapenem-resistant A. baumannii, especially for those for whom colistin is contraindicated because of its toxicity.

Keywords: Acinetobacter; OXA; beta-lactamases; carbapenemase; drug resistance.

MeSH terms

  • Acinetobacter Infections
  • Acinetobacter baumannii*
  • Anti-Bacterial Agents
  • Carbapenems
  • Drug Resistance, Multiple, Bacterial
  • Microbial Sensitivity Tests
  • Minocycline / analogs & derivatives
  • Tigecycline
  • beta-Lactamases

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Tigecycline
  • beta-Lactamases
  • Minocycline