Rev Esp Quimioter 2010:23(2):103-108

A combination of tigecycline, colistin, and meropenem against multidrug-resistant Acinetobacter baumannii bacteremia in a renal transplant recipient: pharmacodynamic and microbiological aspects  

F.J. CANDEL, N. CALVO, J. HEAD, A. SÁNCHEZ, M. MATESANZ, E. CULEBRAS, A. BARRIENTOS, J. PICAZO 

 

Acinetobacter baumannii are emerging as the causal agents of healthcare-associated infections. We describe a renal transplant recipient who developed bacteremia caused by multiresistant A. baumannii, which received a combination of tigecycline, colistin, and meropenem in continuous infusion. The clinical outcome was favorable. In this article we made a molecular study of this multiresistant strain. Our analysis reveals the presence of a bla-OXA-72 gene, a class D of oxacillinase belonging to bla-OXA-40-like group, which constitutes the most disseminated familiy of carbapenemases in Spain. Thus, we found different susceptibility patterns of A. baumannii when we used different Mueller-Hinton agars with different manganese concentrations. Lastly, we explain the combination of these three antibiotics administered to increase microbiologic and pharmacodynamic yield.

 
Rev Esp Quimioter 2010:23(2):103-108 [pdf]