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    Acinetobacter Baumannii, Although Representing A Small Percentage of Gram

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    Marina Domenco
    This study examined Acinetobacter baumannii, a multidrug-resistant bacterium that poses challenges for treatment. From 2011-2014, over 2000 A. baumannii isolates were collected from infections in 453 hospital sites across 48 countries. The isolates were tested for drug susceptibility and resistance. Resistance rates were highest in Europe and the Middle East (>93%) and lowest in North America (47%), with higher rates in ICUs. Susceptibility varied by region, with no drug inhibiting over 70% of isolates. Susceptibility to imipenem was highest in North America (64%) and lowest in Europe/Middle East (≤11%). Amikacin was generally the most effective treatment. Resistance increased over time

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    Acinetobacter Baumannii, Although Representing A Small Percentage of Gram

    Uploaded by

    Marina Domenco
    39 views2 pages
    This study examined Acinetobacter baumannii, a multidrug-resistant bacterium that poses challenges for treatment. From 2011-2014, over 2000 A. baumannii isolates were collected from infections in 453 hospital sites across 48 countries. The isolates were tested for drug susceptibility and resistance. Resistance rates were highest in Europe and the Middle East (>93%) and lowest in North America (47%), with higher rates in ICUs. Susceptibility varied by region, with no drug inhibiting over 70% of isolates. Susceptibility to imipenem was highest in North America (64%) and lowest in Europe/Middle East (≤11%). Amikacin was generally the most effective treatment. Resistance increased over time

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    This study examined Acinetobacter baumannii, a multidrug-resistant bacterium that poses challenges for treatment. From 2011-2014, over 2000 A. baumannii isolates were collected from infections in 453 hospital sites across 48 countries. The isolates were tested for drug susceptibility and resistance. Resistance rates were highest in Europe and the Middle East (>93%) and lowest in North America (47%), with higher rates in ICUs. Susceptibility varied by region, with no drug inhibiting over 70% of isolates. Susceptibility to imipenem was highest in North America (64%) and lowest in Europe/Middle East (≤11%). Amikacin was generally the most effective treatment. Resistance increased over time

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    39 views2 pages

    Acinetobacter Baumannii, Although Representing A Small Percentage of Gram

    Uploaded by

    Marina Domenco
    This study examined Acinetobacter baumannii, a multidrug-resistant bacterium that poses challenges for treatment. From 2011-2014, over 2000 A. baumannii isolates were collected from infections in 453 hospital sites across 48 countries. The isolates were tested for drug susceptibility and resistance. Resistance rates were highest in Europe and the Middle East (>93%) and lowest in North America (47%), with higher rates in ICUs. Susceptibility varied by region, with no drug inhibiting over 70% of isolates. Susceptibility to imipenem was highest in North America (64%) and lowest in Europe/Middle East (≤11%). Amikacin was generally the most effective treatment. Resistance increased over time

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    © All Rights Reserved
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    Download as docx, pdf, or txt
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    Acinetobacter baumannii, although representing a small percentage of Gram-

    negative bacilli isolates in intra-abdominal infections (IAIs) and urinary tract


    infections (UTIs), is frequently multidrug-resistant (MDR) and can pose
    difficult therapeutic challenges. From 2011 to 2014, 2337 A. baumannii were
    collected from IAIs and UTIs at 453 hospital sites in 48 countries as part of
    the SMART ongoing surveillance initiative. Current susceptibility and
    multidrug resistance, defined as resistance to at least three of the tested drug
    classes, were determined in a subset of 1011 isolates from 2013 to 2014. A.
    baumanniicomprised 0.7–4.6% of all aerobic and facultative Gram-negative
    bacilli isolated in six global regions. MDR rates were lowest in North America
    (47%) and highest in Europe and the Middle East (>93%), with higher rates in
    ICUs than in non-ICU wards in almost all regions. Antimicrobial susceptibility
    profiles varied by region but resistance was high everywhere, with no drug
    inhibiting >70% of A. baumannii isolates in any region. Susceptibility to
    imipenem was highest in North America (64%) and lowest in Europe and the
    Middle East (≤11%). Amikacin overall was the most active of the studied
    agents, including against MDR isolates (of which 11–38% were susceptible).
    Trend analysis of only those countries that contributed isolates in each study
    year (2011–2014) demonstrated an increasing trend in MDR rates in the
    Middle East as well as decreasing susceptibility to several single antimicrobial
    agents in Africa, Europe and the Middle East. These patterns and trends can
    help direct antimicrobial therapy and infection control efforts.

    Significance
    Although the multidrug-resistant (MDR) bacterium Acinetobacter baumannii is a serious
    threat for health care systems worldwide, very little is known about the mechanisms that
    have facilitated its rise as a successful pathogen. Our work demonstrates that multiple
    MDR A. baumannii strains regulate the expression of their type VI secretion system (T6SS),
    an antibacterial apparatus used to kill other bacteria, by harboring a large, self-transmissible
    resistance plasmid containing T6SS regulatory genes. Through spontaneous plasmid
    loss, A. baumannii activates its T6SS and is able to outcompete other bacteria. However,
    this comes at a cost, as these strains lose resistance to antibiotics. This mechanism
    constitutes an apparent survival strategy by A. baumannii and provides insights into the
    pathobiology of this important pathogen.

    Abstract
    Infections with Acinetobacter baumannii, one of the most troublesome and least studied
    multidrug-resistant superbugs, are increasing at alarming rates. A. baumannii encodes a
    type VI secretion system (T6SS), an antibacterial apparatus of Gram-negative bacteria
    used to kill competitors. Expression of the T6SS varies among different strains of A.
    baumannii, for which the regulatory mechanisms are unknown. Here, we show that several
    multidrug-resistant strains of A. baumannii harbor a large, self-transmissible resistance
    plasmid that carries the negative regulators for T6SS. T6SS activity is silenced in plasmid-
    containing, antibiotic-resistant cells, while part of the population undergoes frequent plasmid
    loss and activation of the T6SS. This activation results in T6SS-mediated killing of
    competing bacteria but renders A. baumannii susceptible to antibiotics. Our data show that
    a plasmid that has evolved to harbor antibiotic resistance genes plays a role in the
    differentiation of cells specialized in the elimination of competing bacteria.

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