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- Title
Outcomes in patients infected with carbapenem-resistant Acinetobacter baumannii and treated with tigecycline alone or in combination therapy.
- Authors
Guner, R.; Hasanoglu, I.; Keske, S.; Kalem, A.; Tasyaran, M.
- Abstract
Purpose: Acinetobacter baumannii is a non-fermenting aerobic gram-negative bacteria and one of the important nosocomial pathogens, especially in intensive care units (ICUs). In recent years, multidrug-resistant (MDR) isolates have been an emerging problem, with limited therapeutic options. Tigecycline is a novel antimicrobial, with its in vitro activity against most gram-positive and gram-negative pathogens. Methods: This is a retrospective study that was conducted in a tertiary care hospital with 550 beds in Ankara, Turkey, from January 2009 to July 2010. Thirty-three patients who had carbapenem-resistant Acinetobacter spp. infections and received tigecycline alone or in combination with other antibiotics for at least 3 days were included. Results: The median age of the patients was 62 (18-87) years. All of the patients were diagnosed and treated in the ICU. Clinical responses were observed in 23 patients (69.7%). Ten patients (30%) had clinical failure. There was no significant difference between ventilator-associated pneumonia (VAP) and bloodstream infection (BSI) in terms of clinical or microbiological outcome ( p > 0.05). The microbiological response rate was 50%. Superinfection was detected in 13 patients (43.3%) and Pseudomonas aeruginosa was the most frequently isolated pathogen. The 30-day overall mortality rate and attributable mortality rates were 57.6 and 24.2%, respectively. The attributable mortality rate was higher in the group in which microbiological eradication was not provided. Conclusions: Although it is approved by the Food and Drug Administration (FDA) for the treatment of complicated intra-abdominal infections, complicated skin and soft tissue infections, and community-acquired bacterial pneumonia, emerged resistance of Acinetobacter spp. and limited therapeutic options left physicians no choice but to use tigecycline for off-label indications.
- Subjects
TURKEY; OFF-label use (Drugs); ACINETOBACTER infections; AEROBIC bacteria; ANTI-infective agents; COMBINATION drug therapy; CHI-squared test; CROSS infection; DRUG resistance in microorganisms; GRAM-negative bacteria; INTENSIVE care units; HEALTH outcome assessment; T-test (Statistics); TREATMENT effectiveness; RETROSPECTIVE studies; SUPERINFECTION; DATA analysis software; DESCRIPTIVE statistics; THERAPEUTICS
- Publication
Infection, 2011, Vol 39, Issue 6, p515
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-011-0161-1