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A systematic review of implications, mechanisms, and stability of in vivo emergent resistance to colistin and tigecycline in Acinetobacter baumannii .
- Source :
-
Journal of chemotherapy (Florence, Italy) [J Chemother] 2021 Feb; Vol. 33 (1), pp. 1-11. Date of Electronic Publication: 2020 Jul 17. - Publication Year :
- 2021
-
Abstract
- The potential of A. baumannii for acquired resistance to last resort antibiotics (colistin and tigecycline) during treatment has important clinical implications, especially when dealing with patients failing to improve despite treatment with an active antimicrobial. However, the relevant literature remains scattered. Therefore, a systematic search was conducted in PubMed and Scopus. Several studies reported emergence of resistance to colistin or tigecycline during treatment, in most cases (86%) resulting in persistent or recurrent infections, especially in cases of emergent resistance without fitness cost. Lipopolysaccharide modification in the case of colistin and overexpression of efflux pumps in the case of tigecycline were the main mechanisms of resistance. Emergent colistin resistance is often associated with fitness cost which may result in re-emergence of the fitter and more virulent colistin susceptible strain after cessation of antibiotic pressure. Prospective studies are needed to determine the frequency of emergent resistance during treatment and its impact on patient outcomes.
- Subjects :
- Acinetobacter Infections drug therapy
Bacterial Proteins
Calcium-Transporting ATPases genetics
Humans
Lipopolysaccharides metabolism
Membrane Transport Proteins biosynthesis
Microbial Sensitivity Tests
Prospective Studies
Acinetobacter baumannii drug effects
Anti-Bacterial Agents pharmacology
Colistin pharmacology
Drug Resistance, Multiple, Bacterial drug effects
Tigecycline pharmacology
Subjects
Details
- Language :
- English
- ISSN :
- 1973-9478
- Volume :
- 33
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of chemotherapy (Florence, Italy)
- Publication Type :
- Academic Journal
- Accession number :
- 32677578
- Full Text :
- https://doi.org/10.1080/1120009X.2020.1794393