Clinical and in vitro efficacy of colistin plus vancomycin and rifampin against colistin-resistant Acinetobacter baumannii causing ventilator-associated pneumonia

New Microbiol. 2017 Jul;40(3):205-207. Epub 2017 Jul 4.

Abstract

We present the case of a patient with ventilator-associated pneumonia (VAP) caused by a pan-resistant Acinetobacter baumannii successfully treated with the combination colistin plus vancomycin plus rifampin, whose in vitro activity was investigated by checkerboard method and killing testing. Furthermore, the serum bactericidal activity (SBA) was assessed. Our case shows that an innovative regimen consisting of colistin plus antimicrobials active only against Gram-positive microorganisms might represent a valid therapeutic option for severe infections caused by colistin-resistant A. baumannii.

Keywords: Acinetobacter baumannii; Colistin resistance; Multi-drug resistance; Vancomycin, Rifampin; Ventilator-associated pneumonia.

Publication types

  • Case Reports

MeSH terms

  • Acinetobacter Infections / drug therapy
  • Acinetobacter Infections / microbiology*
  • Acinetobacter baumannii / drug effects*
  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotics, Antitubercular / pharmacology
  • Antibiotics, Antitubercular / therapeutic use
  • Colistin / pharmacology*
  • Colistin / therapeutic use
  • Drug Resistance, Multiple, Bacterial
  • Drug Therapy, Combination
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Neurosurgical Procedures
  • Pneumonia, Ventilator-Associated / drug therapy
  • Pneumonia, Ventilator-Associated / microbiology*
  • Rifampin / pharmacology
  • Rifampin / therapeutic use
  • Subarachnoid Hemorrhage / surgery
  • Vancomycin / pharmacology
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Antibiotics, Antitubercular
  • Vancomycin
  • Rifampin
  • Colistin