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548. Carbapenem-Resistant Acinetobacter baumannii Antibiotic Susceptibility Testing and Antibiogram Formation, Connecticut 2017–2019

BACKGROUND: Carbapenem-resistant Acinetobacter baumanii (CRAB) is an infectious disease threat with limited treatment options. Statewide CRAB reporting and isolate submission has been mandated in Connecticut (CT) since 2017, which allowed the creation of a statewide CRAB antibiogram to assist with e...

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Autores principales: Paranandi, Anu, Maloney, Meghan, Grogan, Erin, Macierowski, Bobbie, Noel, Diane, Razeq, Jafar, Muyombwe, Anthony, Leung, Vivian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811012/
http://dx.doi.org/10.1093/ofid/ofz360.617
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author Paranandi, Anu
Maloney, Meghan
Grogan, Erin
Macierowski, Bobbie
Noel, Diane
Razeq, Jafar
Muyombwe, Anthony
Leung, Vivian
author_facet Paranandi, Anu
Maloney, Meghan
Grogan, Erin
Macierowski, Bobbie
Noel, Diane
Razeq, Jafar
Muyombwe, Anthony
Leung, Vivian
author_sort Paranandi, Anu
collection PubMed
description BACKGROUND: Carbapenem-resistant Acinetobacter baumanii (CRAB) is an infectious disease threat with limited treatment options. Statewide CRAB reporting and isolate submission has been mandated in Connecticut (CT) since 2017, which allowed the creation of a statewide CRAB antibiogram to assist with empiric treatment options for CRAB. METHODS: Clinical CRAB isolates from 2017 through the first quarter of 2019 underwent carbapenemase and expanded susceptibility testing at the CT State Public Health Laboratory or the Antibiotic Resistance Laboratory Network regional lab for carbapenemase and expanded susceptibility testing. Susceptibility testing was done by broth microdilution and disk diffusion, and interpreted using Clinical and Laboratory Standards Institute breakpoints. Carbapenemase producers were detected by the modified carbapenem inactivation method. Polymerase chain reaction testing identified carbapenemase genes. RESULTS: Of the 64 CRAB isolates submitted, 40 remained after confirmation of carbapenem resistance, i.e., resistance to at least one carbapenem, and deduplication of patients. Of these, 19 were carbapenemase producers (CP), and 21 were non-carpabenemase producers (Non-CP). All isolates were non-susceptible to cefepime, ceftazidime, levofloxacin and all carbapenems. Colistin susceptibilities were available for 33 isolates, 32 (97%) of which were susceptible. Tobramycin susceptibilities were available for 31 isolates, only 10 (32%) of which were susceptible. Of the CP, all 15 were susceptible to colistin, but only 2 (14%) were susceptible to tobramycin. Of the Non-CP, 16 (89%) were susceptible to colistin, and 8 (47%) were susceptible to tobramycin. Most CRABs had a tigecycline minimum inhibitory concentration (MIC) of ≤2 μg/mL, with a higher proportion of Non-CP with lower MIC values than CP. CONCLUSION: CRAB shows resistance to all carbapenems, and most non-carbapenem antibiotics except colistin and in rare circumstances tobramycin. Most CRAB isolates had tigecycline MICs of ≤2 μg/mL. The statewide antibiogram illustrates the lack of approved antibiotics for the treatment of CRAB, underscoring the importance of further antibiotic development for CRAB treatment. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68110122019-10-28 548. Carbapenem-Resistant Acinetobacter baumannii Antibiotic Susceptibility Testing and Antibiogram Formation, Connecticut 2017–2019 Paranandi, Anu Maloney, Meghan Grogan, Erin Macierowski, Bobbie Noel, Diane Razeq, Jafar Muyombwe, Anthony Leung, Vivian Open Forum Infect Dis Abstracts BACKGROUND: Carbapenem-resistant Acinetobacter baumanii (CRAB) is an infectious disease threat with limited treatment options. Statewide CRAB reporting and isolate submission has been mandated in Connecticut (CT) since 2017, which allowed the creation of a statewide CRAB antibiogram to assist with empiric treatment options for CRAB. METHODS: Clinical CRAB isolates from 2017 through the first quarter of 2019 underwent carbapenemase and expanded susceptibility testing at the CT State Public Health Laboratory or the Antibiotic Resistance Laboratory Network regional lab for carbapenemase and expanded susceptibility testing. Susceptibility testing was done by broth microdilution and disk diffusion, and interpreted using Clinical and Laboratory Standards Institute breakpoints. Carbapenemase producers were detected by the modified carbapenem inactivation method. Polymerase chain reaction testing identified carbapenemase genes. RESULTS: Of the 64 CRAB isolates submitted, 40 remained after confirmation of carbapenem resistance, i.e., resistance to at least one carbapenem, and deduplication of patients. Of these, 19 were carbapenemase producers (CP), and 21 were non-carpabenemase producers (Non-CP). All isolates were non-susceptible to cefepime, ceftazidime, levofloxacin and all carbapenems. Colistin susceptibilities were available for 33 isolates, 32 (97%) of which were susceptible. Tobramycin susceptibilities were available for 31 isolates, only 10 (32%) of which were susceptible. Of the CP, all 15 were susceptible to colistin, but only 2 (14%) were susceptible to tobramycin. Of the Non-CP, 16 (89%) were susceptible to colistin, and 8 (47%) were susceptible to tobramycin. Most CRABs had a tigecycline minimum inhibitory concentration (MIC) of ≤2 μg/mL, with a higher proportion of Non-CP with lower MIC values than CP. CONCLUSION: CRAB shows resistance to all carbapenems, and most non-carbapenem antibiotics except colistin and in rare circumstances tobramycin. Most CRAB isolates had tigecycline MICs of ≤2 μg/mL. The statewide antibiogram illustrates the lack of approved antibiotics for the treatment of CRAB, underscoring the importance of further antibiotic development for CRAB treatment. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6811012/ http://dx.doi.org/10.1093/ofid/ofz360.617 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Paranandi, Anu
Maloney, Meghan
Grogan, Erin
Macierowski, Bobbie
Noel, Diane
Razeq, Jafar
Muyombwe, Anthony
Leung, Vivian
548. Carbapenem-Resistant Acinetobacter baumannii Antibiotic Susceptibility Testing and Antibiogram Formation, Connecticut 2017–2019
title 548. Carbapenem-Resistant Acinetobacter baumannii Antibiotic Susceptibility Testing and Antibiogram Formation, Connecticut 2017–2019
title_full 548. Carbapenem-Resistant Acinetobacter baumannii Antibiotic Susceptibility Testing and Antibiogram Formation, Connecticut 2017–2019
title_fullStr 548. Carbapenem-Resistant Acinetobacter baumannii Antibiotic Susceptibility Testing and Antibiogram Formation, Connecticut 2017–2019
title_full_unstemmed 548. Carbapenem-Resistant Acinetobacter baumannii Antibiotic Susceptibility Testing and Antibiogram Formation, Connecticut 2017–2019
title_short 548. Carbapenem-Resistant Acinetobacter baumannii Antibiotic Susceptibility Testing and Antibiogram Formation, Connecticut 2017–2019
title_sort 548. carbapenem-resistant acinetobacter baumannii antibiotic susceptibility testing and antibiogram formation, connecticut 2017–2019
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811012/
http://dx.doi.org/10.1093/ofid/ofz360.617
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