title: Successful treatment of skin and soft tissue infection due to carbapenem-resistant Acinetobacter baumannii by ampicillin-sulbactam and meropenem combination therapy.
abstract: In recent years, carbapenem-resistant Acinetobacter baumannii infections have been responsible for outbreaks in medical facilities. A 35-year-old Japanese woman developed a skin and soft tissue infection due to carbapenem-resistant A. baumannii. The isolate was resistant to antibiotics other than ampicillin-sulbactam and colistin, suggesting drug resistance due to carbapenemase production by OXA-23. We selected a combination therapy consisting of intravenous ampicillin-sulbactam and meropenem. No changes were observed in aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, or serum creatinine during therapy, and carbapenem-resistant A. baumannii was not detected in wound exudates 3 days after therapy initiation. In our patient's case, combination therapy with ampicillin-sulbactam and meropenem was successful. Thus, combination therapy with ampicillin-sulbactam and meropenem is effective against skin and soft tissue infection due to carbapenem-resistant A. baumannii. Combination therapy with intravenous ampicillin-sulbactam and meropenem may be an option for skin and soft tissue infections due to carbapenem-resistant A. baumannii.
authors.affiliation: Department of Infection Control Unit, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan. Electronic address: hiraki@kumamoto2.hosp.go.jp.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiraki
authors.forename: Mayumi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Yoko
authors.initials: Y
authors.lastname: Masuda
authors.forename: Daisuke
authors.initials: D
authors.lastname: Inoue
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsuji
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Kamimura
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Karube
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Takaki
authors.forename: Fumio
authors.initials: F
authors.lastname: Kawano
mesh_terms: D000151:Acinetobacter Infections / Q000175:diagnosis / Q000188:drug therapy*; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification; D000328:Adult; D000667:Ampicillin / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015780:Carbapenems / Q000494:pharmacology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077731:Meropenem; D008826:Microbial Sensitivity Tests; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000188:drug therapy*; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D013407:Sulbactam / Q000494:pharmacology / Q000627:therapeutic use; D013845:Thienamycins / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D013845:Thienamycins; C035444:sultamicillin; D000667:Ampicillin; D000077731:Meropenem; D013407:Sulbactam
keywords: Acinetobacter baumannii; Carbapenem resistance; Meropenem; Soft tissue infection; Sulbactam