title: High mortality rates among solid organ transplant recipients infected with extensively drug-resistant Acinetobacter baumannii: using in vitro antibiotic combination testing to identify the combination of a carbapenem and colistin as an effective treatment regimen.
abstract: Extensively drug-resistant (XDR) Acinetobacter baumannii infections caused 91% (10/11) mortality in transplant recipients. Isolates were colistin-susceptible initially, but susceptibility decreased during therapy in 40% (4/10). We tested antibiotic combinations against XDR Acinetobacter in vitro and demonstrated positive interactions for carbapenem-colistin. Subsequently, 80% (4/5) of transplant patients were treated successfully with carbepenem-colistin regimens.
authors.affiliation: University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
authors.forename: Ryan K
authors.initials: RK
authors.lastname: Shields
authors.forename: Eun J
authors.initials: EJ
authors.lastname: Kwak
authors.forename: Brian A
authors.initials: BA
authors.lastname: Potoski
authors.forename: Yohei
authors.initials: Y
authors.lastname: Doi
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Adams-Haduch
authors.forename: Fernanda P
authors.initials: FP
authors.lastname: Silviera
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Toyoda
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Pilewski
authors.forename: Maria
authors.initials: M
authors.lastname: Crespo
authors.forename: A William
authors.initials: AW
authors.lastname: Pasculle
authors.forename: Cornelius J
authors.initials: CJ
authors.lastname: Clancy
authors.forename: M Hong
authors.initials: MH
authors.lastname: Nguyen
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D015780:Carbapenems / Q000008:administration & dosage / Q000494:pharmacology; D003091:Colistin / Q000008:administration & dosage / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial; D004357:Drug Synergism; D004359:Drug Therapy, Combination / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D050296:Microbial Viability; D008875:Middle Aged; D016377:Organ Transplantation; D014180:Transplantation; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D003091:Colistin