A combination of tigecycline, colistin, and meropenem against multidrug-resistant Acinetobacter baumannii bacteremia in a renal transplant recipient: pharmacodynamic and microbiological aspects

作者：Candel F J^*; Calvo N; Head J; Sanchez A; Matesanz M; Culebras E; Barrientos A; Picazo J

来源：Revista Espanola de Quimioterapia, 2010, 23(2): 103-108.

• Multirresistant Acinetobacter baumannii
• bacteremia
• tigecycline
• colistin
• continuous infusion of meropenem
• Manganese
• Mueller-Hinton agar

Acinetobacter baumannii are emerging as the causal agents of healthcare-associated infections. We describe a renal transplant recipient who developed bacteremia caused by multiresistant A. baumannii, which received a combination of tigecycline, colistin, and meropenem in continuous infusion. The clinical outcome was favorable. In this article we made a molecular study of this multiresistant strain. Our analysis reveals the presence of a bla-(OXA-72) gene, a class D of oxacillinase belonging to bla-(OXA-40)-like group, which constitutes the most disseminated familiy of carbapenemases in Spain. Thus, we found different susceptibility patterns of A. baumannii when we used different Mueller-Hinton agars with different manganese concentrations. Lastly, we explain the combination of these three antibiotics administered to increase microbiologic and pharmacodynamic yield.

• 出版日期2010-6