Prevalence and Clinical Consequences of Colistin Heteroresistance and Evolution into Full Resistance in Carbapenem-Resistant Acinetobacter baumannii

Author:

Kon Hadas1,Hameir Amichay1,Nutman Amir12,Temkin Elizabeth1,Keren Paz Alona1,Lellouche Jonathan13,Schwartz David1,Weiss David S.4,Kaye Keith S.5,Daikos George L.67,Skiada Anna67,Durante-Mangoni Emanuele89ORCID,Dishon Benattar Yael1011,Yahav Dafna212ORCID,Daitch Vered213,Bernardo Mariano14,Iossa Domenico8,Friberg Lena E.15,Theuretzbacher Ursula16,Leibovici Leonard213,Dickstein Yaakov10,Pollak Dina17,Mendelsohn Sigal17,Paul Mical10,Carmeli Yehuda12,Paul Mical,Dishon Benattar Yael,Dickstein Yaakov,Bitterman Roni,Zayyad Hiba,Koppel Fidi,Zak-Doron Yael,Altunin Sergey,Andria Nizar,Neuberger Ami,Stern Anat,Petersiel Neta,Raines Marina,Karban Amir,Leibovici Leonard,Yahav Dafna,Eliakim-Raz Noa,Zusman Oren,Elbaz Michal,Atamna Heyam,Daitch Vered,Babich Tanya,Carmeli Yehuda,Nutman Amir,Adler Amos,Levi Inbar,Daikos George L.,Skiada Anna,Pavleas Ioannis,Antoniadou Anastasia,Kotsaki Antigoni,Durante-Mangoni Emanuele,Andini Roberto,Iossa Domenico,Bernardo Mariano,Cavezza Giusi,Bertolino Lorenzo,Giuffre Giuseppe,Giurazza Roberto,Ruocco Giuseppe,Galdo Maria,Murino Patrizia,Cristinziano Adriano,Corcione Antonio,Zampino Rosa,Mouton Johan,Friberg Lena,Theuretzbacher Ursula

Affiliation:

1. National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health, Tel Aviv, Israel

2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

3. Adelson School of Medicine, Ariel University, Israel

4. Emory Antibiotic Resistance Center, Emory University School of Medicine, Atlanta, Georgia, USA

5. Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA

6. First Department of Medicine, Laikon General Hospital, Athens, Greece

7. National and Kapodistrian University of Athens, Athens, Greece

8. Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy

9. AORN dei Colli-Monaldi Hospital, Naples, Italy

10. Institute of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel

11. Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel

12. Infectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel

13. Department of Medicine E, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel

14. Microbiology and Virology Unit, AORN Ospedali dei Colli-Monaldi Hospital, Naples, Italy

15. Department of Pharmacy, Uppsala University, Uppsala, Sweden

16. Center for Anti-Infective Agents, Vienna, Austria

17. Microbiology Laboratory, Rambam Health Care Campus, Haifa, Israel

Abstract

To our knowledge, this is the first large-scale study to report on HR in Gram-negative bacteria. We described the prevalence of colistin HR in a large sample of carbapenem-resistant A. baumannii isolates, the evolution of many colistin HR isolates to a resistant phenotype following colistin exposure and withdrawal, and the clinical consequences of colistin HR.

Funder

EU AIDA grant

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Cell Biology,Microbiology (medical),Genetics,General Immunology and Microbiology,Ecology,Physiology

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