Colistin resistance of Acinetobacter baumannii: clinical reports, mechanisms and antimicrobial strategies

被引:432
作者
Cai, Yun [1 ]
Chai, Dong [1 ]
Wang, Rui [1 ]
Liang, Beibei [1 ]
Bai, Nan [1 ]
机构
[1] Peoples Liberat Army Gen Hosp, Dept Clin Pharmacol, Beijing 100853, Peoples R China
基金
北京市自然科学基金; 中国国家自然科学基金;
关键词
multidrug resistance; heteroresistance; combination therapy; IN-VITRO ACTIVITY; MELITTIN HYBRID PEPTIDES; CRITICALLY-ILL PATIENTS; METALLO-BETA-LACTAMASE; POLYMYXIN-B; PSEUDOMONAS-AERUGINOSA; TIGECYCLINE RESISTANCE; INFECTIOUS-DISEASES; COMBINATION; LIPOPOLYSACCHARIDE;
D O I
10.1093/jac/dks084
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Colistin is the last resort for treatment of multidrug-resistant Acinetobacter baumannii. Unfortunately, resistance to colistin has been reported all over the world. The highest resistance rate was reported in Asia, followed by Europe. The heteroresistance rate of A. baumannii to colistin is generally higher than the resistance rate. The mechanism of resistance might be loss of lipopolysaccharide or/and the PmrAB two-component system. Pharmacokinetic/pharmacodynamic studies revealed that colistin monotherapy is unable to prevent resistance, and combination therapy might be the best antimicrobial strategy against colistin-resistant A. baumannii. Colistin/rifampicin and colistin/carbapenem are the most studied combinations that showed promising results in vitro, in vivo and in the clinic. New peptides showing good activity against colistin-resistant A. baumannii are also being investigated.
引用
收藏
页码:1607 / 1615
页数:9
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