Multidrug-resistant Acinetobacter baumannii: mechanisms of virulence and resistance

International Journal of Antimicrobial Agents

Volumn 35, Issue 3, 2010, Pages 219-226

  Gordon, Nicola C ^a   Wareham, David W ^a,b  

^a BARTS HEALTH NHS TRUST   (United Kingdom)

^b QUEEN MARY UNIVERSITY OF LONDON   (United Kingdom)

Author keywords

Acinetobacter baumannii; Antimicrobial resistance; Pathogenesis

Indexed keywords

AMIKACIN; AMINOGLYCOSIDE ANTIBIOTIC AGENT; AMPICILLIN; ANTIBIOTIC AGENT; ANTIINFECTIVE AGENT; BACTERIAL ENZYME; BETA LACTAM ANTIBIOTIC; BETA LACTAMASE; CARBAPENEM; CARBAPENEM DERIVATIVE; CHLORAMPHENICOL; CIPROFLOXACIN; COLISTIN; COTRIMOXAZOLE; ERYTHROMYCIN; GLYCYLCYCLINE DERIVATIVE; IMIPENEM; LEVOFLOXACIN; MACROLIDE; MEROPENEM; PENICILLIN DERIVATIVE; PIPERACILLIN PLUS TAZOBACTAM; POLYMYXIN DERIVATIVE; QUINOLINE DERIVED ANTIINFECTIVE AGENT; RIFAMPICIN; SULBACTAM; SULTAMICILLIN; TETRACYCLINE DERIVATIVE; TIGECYCLINE; UNINDEXED DRUG;

ABDOMINAL INFECTION; ACINETOBACTER BAUMANNII; ACINETOBACTER INFECTION; ANTIBIOTIC RESISTANCE; BACTEREMIA; BACTERIAL COLONIZATION; BACTERIAL GENE; BACTERIAL STRAIN; BACTERIAL SURVIVAL; BACTERIAL VIRULENCE; BACTERIUM ISOLATE; BIOFILM; BLOODSTREAM INFECTION; CLINICAL TRIAL; DISEASE COURSE; DRUG BLOOD LEVEL; DRUG EFFICACY; DRUG MEGADOSE; DRUG PENETRATION; DRUG POTENTIATION; EPIDEMIC; GENETIC VARIABILITY; GRAM NEGATIVE SEPSIS; HOST PATHOGEN INTERACTION; HUMAN; IMMUNE RESPONSE; MICROBIAL ACTIVITY; MONOTHERAPY; MORTALITY; MULTIDRUG RESISTANCE; NEUROTOXICITY; NONHUMAN; PATHOGENESIS; PRIORITY JOURNAL; RESPIRATORY TRACT INFECTION; SHORT SURVEY; SKIN INFECTION; SOFT TISSUE INFECTION; TREATMENT RESPONSE; URINARY TRACT INFECTION; VENTILATOR ASSOCIATED PNEUMONIA;

ACINETOBACTER BAUMANNII; ACINETOBACTER INFECTIONS; ANTI-BACTERIAL AGENTS; BACTERIAL PROTEINS; DRUG RESISTANCE, MULTIPLE, BACTERIAL; HUMANS; VIRULENCE; VIRULENCE FACTORS;

EID: 73549086738     PISSN: 09248579     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.ijantimicag.2009.10.024     Document Type: Short Survey

References (163)

1. Beijerinck M.W. Pigmenten als oxydatieproducten gevormd door bacterien. Versl Koninklijke Akad Wetensch 19 (1911) 1092-1103
2. Gould I.M. The epidemiology of antibiotic resistance. Int J Antimicrob Agents 32 Suppl. 1 (2008) S2-S9
3. Vallenet D., Nordmann P., Barbe V., Poirel L., Mangenot S., Bataille E., et al. Comparative analysis of acinetobacters: three genomes for three lifestyles. PLoS One 19 (2008) e1805
4. Smith M.G., Gianoulis T.A., Pukatzki S., Mekalanos J.J., Ornston L.N., Gerstein M., et al. New insights into Acinetobacter baumannii pathogenesis revealed by high-density pyrosequencing and transposon mutagenesis. Genes Dev 21 (2007) 601-614
5. Lee H.W., Kah Y.M., Kim J., Lee J.C., Seol S.Y., Cho D.T., et al. Capacity of multidrug-resistant clinical isolates of Acinetobacter baumannii to form biofilm and adhere to epithelial cell surfaces. Clin Microbiol Infect 14 (2008) 49-54
6. Cevahir N., Demir M., Kaleli I., Gurbuz M., and Tikvesli S. Evaluation of biofilm production, gelatinase activity, and mannose-resistant haemagglutination in Acinetobacter baumannii strains. J Microbiol Immunol Infect 41 (2008) 513-518
7. Vidal R., Dominguez M., Urrutia H., Bello H., Gonzalez G., Garcia A., et al. Biofilm formation by Acinetobacter baumannii. Microbios 86 (1996) 49-58
8. Gaddy J.A., and Actis L.A. Regulation of Acinetobacter baumannii biofilm formation. Future Microbiol 4 (2009) 273-278
9. Siroy A., Cosette P., Seyer D., Lemaître-Guillier C., Vallenet D., Van Dorsselaer A., et al. Global comparison of the membrane subproteomes between a multidrug-resistant Acinetobacter baumannii strain and a reference strain. J Proteome Res 5 (2006) 3385-3398
10. Rodríguez-Baño J., Martí S., Soto S., Fernández-Cuenca F., Cisneros J.M., Pachón J., et al. Biofilm formation in Acinetobacter baumannii: associated features and clinical implications. Clin Microbiol Infect 14 (2008) 276-278
11. Lee J.C., Koerten H., van den Broek P., Beekhuizen H., Wolterbeek R., van den Barselaar M., et al. Adherence of Acinetobacter baumannii strains to human bronchial epithelial cells. Res Microbiol 157 (2006) 360-366
12. de Breij A., Gaddy J., van der Meer J., Koning R., Koster A., van den Broek P., et al. CsuA/BABCDE-dependent pili are not involved in the adherence of Acinetobacter baumannii ATCC19606(T) to human airway epithelial cells and their inflammatory response. Res Microbiol 160 (2009) 213-218
13. Choi C.H., Lee J.S., Lee Y.C., Park T.I., and Lee J.C. Acinetobacter baumannii epithelial cells and outer membrane protein A mediates interactions with epithelial cells. BMC Microbiol 8 (2008) 216
14. Choi C.H., Lee E.Y., Lee Y.C., Park T.I., Kim H.J., Hyun S.H., et al. Outer membrane protein 38 of Acinetobacter baumannii localizes to the mitochondria and induces apoptosis of epithelial cells. Cell Microbiol 7 (2005) 1127-1138
15. Choi C.H., Hyun S.H., Lee J.Y., Lee J.S., Lee Y.S., Kim S.A., et al. Acinetobacter baumannii outer membrane protein A targets the nucleus and induces cytotoxicity. Cell Microbiol 10 (2008) 309-319
16. + T cells toward a Th1 polarizing phenotype through the activation of dendritic cells. Biochem Pharmacol 74 (2007) 86-97
17. Kim S.A., Yoo S.M., Hyun S.H., Choi C.H., Yang S.Y., Kim H.J., et al. Global gene expression patterns and induction of innate immune response in human laryngeal epithelial cells in response to Acinetobacter baumannii outer membrane protein A. FEMS Immunol Med Microbiol 54 (2008) 45-52
18. Zimbler D.L., Penwell W.F., Gaddy J.A., Menke S.M., Tomaras A.P., Connerly P.L., et al. Iron acquisition functions expressed by the human pathogen Acinetobacter baumannii. Biometals 22 (2009) 23-32
19. Dorsey C.W., Beglin M.S., and Actis L.A. Detection and analysis of iron uptake components expressed by Acinetobacter baumannii clinical isolates. J Clin Microbiol 41 (2003) 4188-4193
20. Smith A.W., and Alpar K.E. Immune response to Acinetobacter calcoaceticus infection in man. J Med Microbiol 34 (1991) 83-88
21. Erridge C., Moncayo-Nieto O., Morgan R., Young M., and Poxton I.R. Acinetobacter baumannii lipopolysaccharides are potent stimulators of human monocyte activation via Toll-like receptor 4 signalling. J Med Microbiol 56 (2007) 165-171
22. Grupper M., Sprecher H., Mashiach T., and Finkelstein R. Attributable mortality of nosocomial Acinetobacter bacteremia. Infect Control Hosp Epidemiol 28 (2007) 293-298
23. Lee N.Y., Lee H.C., Ko N.Y., Chang C.M., Shih H.I., Wu C.J., et al. Clinical and economic impact of multidrug resistance in nosocomial Acinetobacter baumannii bacteraemia. Infect Control Hosp Epidemiol 28 (2007) 713-719
24. Abbo A., Carmeli Y., Navon-Venezia S., Siegman-Igra Y., and Schwaber M.J. Impact of multi-drug-resistant Acinetobacter baumannii on clinical outcomes. Eur J Clin Microbiol Infect Dis 26 (2007) 793-800
25. Blot S., Vandewoude K., and Colardyn F. Nosocomial bacteraemia involving Acinetobacter baumannii in critically ill patients: a matched cohort study. Intensive Care Med 29 (2003) 471-475
26. Sunenshine R.H., Wright M.O., Maragakis L.L., Harris A.D., Song X., Hebden J., et al. Multidrug-resistant Acinetobacter infection mortality rate and length of hospitalization. Emerg Infect Dis 13 (2007) 97-103
27. Jang T.N., Lee S.H., Huang C.H., Lee C.L., and Chen W.Y. Risk factors and impact of nosocomial Acinetobacter baumannii bloodstream infections in the adult intensive care unit: a case-control study. J Hosp Infect 73 (2009) 143-150
28. Albrecht M.A., Griffith M.E., Murray C.K., Chung K.K., Horvath E.E., Ward J.A., et al. Impact of Acinetobacter infection on the mortality of burn patients. J Am Coll Surg 203 (2006) 546-550
29. Kwon K.T., Oh W.S., Song J.H., Chang H.H., Jung S.I., Kim S.W., et al. Impact of imipenem resistance on mortality in patients with Acinetobacter bacteraemia. J Antimicrob Chemother 59 (2007) 525-530
30. Wareham D.W., Bean D.C., Khanna P., Hennesy E.M., Krahe D., Ely A., et al. Bloodstream infection due to Acinetobacter spp.: epidemiology, risk factors and impact of multi-drug resistance. Eur J Clin Microbiol Infect Dis 27 (2008) 607-612
31. Loh L.C., Yii C.T., Lai K.K., Seevaunnamtum S.P., Pushparasah G., and Tong J.M. Acinetobacter baumannii respiratory isolates in ventilated patients are associated with prolonged hospital stay. Clin Microbiol Infect 12 (2006) 597-598
32. Falagas M.E., Bliziotis I.A., and Siempos I.I. Attributable mortality of Acinetobacter baumannii infections in critically ill patients: a systematic review of matched cohort and case-control studies. Crit Care 10 (2006) R48
33. Falagas M.E., Koletsi P.K., and Bliziotis I.A. The diversity of definitions of multidrug-resistant (MDR) and pandrug-resistant (PDR) Acinetobacter baumannii and Pseudomonas aeruginosa. J Med Microbiol 55 (2006) 1619-1629
34. Morgan D.J., Weisenberg S.A., Augenbraun M.H., Calfee D.P., Currie B.P., Furuya E.Y., et al. Multidrug-resistant Acinetobacter baumannii in New York City-10 years into the epidemic. Infect Control Hosp Epidemiol 30 (2009) 196-197
35. Rossolini G.M., and Mantengoli E. Antimicrobial resistance in Europe and its potential impact on empirical therapy. Clin Microbiol Infect 14 Suppl. 6 (2008) 2-8
36. Livermore D.M., Hope R., Brick G., Lillie M., Reynolds R., and BSAC Working Parties on Resistance Surveillance. Non-susceptibility trends among Pseudomonas aeruginosa and other non-fermentative Gram-negative bacteria from bacteraemias in the UK and Ireland, 2001-06. J Antimicrob Chemother 62 Suppl. 2 (2008) ii55-ii63
37. Fournier P.E., Vallenet D., Barbe V., Audic S., Ogata H., Poirel L., et al. Comparative genomics of multidrug resistance in Acinetobacter baumannii. PLoS Genet 2 (2006) e7
38. Iacono M., Villa L., Fortini D., Bordoni R., Imperi F., Bonnal R.J., et al. Whole-genome pyrosequencing of an epidemic multidrug-resistant Acinetobacter baumannii strain belonging to the European clone II group. Antimicrob Agents Chemother 52 (2008) 2616-2625
39. Adams M.D., Goglin K., Molyneaux N., Hujer K.M., Lavender H., Jamison J.J., et al. Comparative genome sequence analysis of multidrug-resistant Acinetobacter baumannii. J Bacteriol 190 (2008) 8053-8064
40. Post V., and Hall R.M. AbaR5, a large multiple-antibiotic resistance region found in Acinetobacter baumannii. Antimicrob Agents Chemother 53 (2009) 2667-2671
41. Bou G., and Martínez-Beltrán J. Cloning, nucleotide sequencing, and analysis of the gene encoding an AmpC β-lactamase in Acinetobacter baumannii. Antimicrob Agents Chemother 44 (2000) 428-432
42. Corvec S., Caroff N., Espaze E., Giraudeau C., Drugeon H., and Reynaud A. AmpC cephalosporinase hyperproduction in Acinetobacter baumannii clinical strains. J Antimicrob Chemother 52 (2003) 629-635
43. Hujer K.M., Hamza N.S., Hujer A.M., Perez F., Helfand M.S., Bethel C.R., et al. Identification of a new allelic variant of the Acinetobacter baumannii cephalosporinase, ADC-7 β-lactamase: defining a unique family of class C enzymes. Antimicrob Agents Chemother 49 (2005) 2941-2948
44. ABA-1 customized for Acinetobacter?. FEMS Microbiol Lett 243 (2005) 425-429
45. Héritier C., Poirel L., and Nordmann P. Cephalosporinase over-expression resulting from insertion of ISAba1 in Acinetobacter baumannii. Clin Microbiol Infect 12 (2006) 123-130
46. Poirel L., Menuteau O., Agoli N., Cattoen C., and Nordmann P. Outbreak of extended-spectrum β-lactamase VEB-1-producing isolates of Acinetobacter baumannii in a French hospital. J Clin Microbiol 41 (2003) 3542-3547
47. Carbonne A., Naas T., Blanckaert K., Couzigou C., Cattoen C., Chagnon J.L., et al. Investigation of a nosocomial outbreak of extended-spectrum β-lactamase VEB-1-producing isolates of Acinetobacter baumannii in a hospital setting. J Hosp Infect 60 (2005) 14-18
48. Naas T., Coignard B., Carbonne A., Blanckaert K., Bajolet O., Bernet C., et al. VEB-1 extended-spectrum β-lactamase-producing Acinetobacter baumannii, France. Emerg Infect Dis 12 (2006) 1214-1222
49. Pasterán F., Rapoport M., Petroni A., Faccone D., Corso A., Galas M., et al. Emergence of PER-2 and VEB-1a in Acinetobacter baumannii strains in the Americas. Antimicrob Agents Chemother 50 (2006) 3222-3224
50. Naas T., Bogaerts P., Bauraing C., Degheldre Y., Glupczynski Y., and Nordmann P. Emergence of PER and VEB extended-spectrum β-lactamases in Acinetobacter baumannii in Belgium. J Antimicrob Chemother 58 (2006) 178-182
51. Vahaboglu H., Coskunkan F., Tansel O., Ozturk R., Sahin N., Koksal I., et al. Clinical importance of extended-spectrum β-lactamase (PER-1-type)-producing Acinetobacter spp. and Pseudomonas aeruginosa strains. J Med Microbiol 50 (2001) 642-645
52. Yong D., Shin J.H., Kim S., Lim Y., Yum J.H., Lee K., et al. High prevalence of PER-1 extended-spectrum β-lactamase-producing Acinetobacter spp. in Korea. Antimicrob Agents Chemother 47 (2003) 1749-1751
53. Jeong S.H., Bae I.K., Kwon S.B., Lee K., Yong D., Woo G.J., et al. Investigation of a nosocomial outbreak of Acinetobacter baumannii producing PER-1 extended-spectrum β-lactamase in an intensive care unit. J Hosp Infect 59 (2005) 242-248
54. PER-2 β-lactamase genes in clinical isolates from Bolivian hospitals. J Antimicrob Chemother 57 (2006) 975-978
55. Strateva T., Todorova A., Ouzounova-Raykova V., and Mitov I. Emergence of a PER-1 extended-spectrum β-lactamase-producing Acinetobacter baumannii clinical isolate in Bulgaria. J Chemother 20 (2008) 391-392
56. PER-1 and armA in a Korean hospital. Clin Microbiol Infect 14 (2008) 716-718
57. Szabó D., Szentandrássy J., Juhász Z., Katona K., Nagy K., and Rókusz L. Imported PER-1 producing Pseudomonas aeruginosa, PER-1 producing Acinetobacter baumanii and VIM-2-producing Pseudomonas aeruginosa strains in Hungary. Ann Clin Microbiol Antimicrob 30 (2008) 12
58. Naiemi N.A., Duim B., Savelkoul P.H., Spanjaard L., de Jonge E., Bart A., et al. Widespread transfer of resistance genes between bacterial species in an intensive care unit: implications for hospital epidemiology. J Clin Microbiol 43 (2005) 4862-4864
59. Endimiani A., Luzzaro F., Migliavacca R., Mantengoli E., Hujer A.M., Hujer K.M., et al. Spread in an Italian hospital of a clonal Acinetobacter baumannii strain producing the TEM-92 extended-spectrum β-lactamase. Antimicrob Agents Chemother 51 (2007) 2211-2214
60. Naas T., Namdari F., Réglier-Poupet H., Poyart C., and Nordmann P. Panresistant extended-spectrum β-lactamase SHV-5-producing Acinetobacter baumannii from New York City. J Antimicrob Chemother 60 (2007) 1174-1176
61. Nagano N., Nagano Y., Cordevant C., Shibata N., and Arakawa Y. Nosocomial transmission of CTX-M-2 β-lactamase-producing Acinetobacter baumannii in a neurosurgery ward. J Clin Microbiol 42 (2004) 3978-3984
62. Sabtcheva S., Saga T., Kantardjiev T., Ivanova M., Ishii Y., and Kaku M. Nosocomial spread of armA-mediated high-level aminoglycoside resistance in Enterobacteriaceae isolates producing CTX-M-3 β-lactamase in a cancer hospital in Bulgaria. J Chemother 20 (2008) 593-599
63. Poirel L., Corvec S., Rapoport M., Mugnier P., Petroni A., Pasteran F., et al. Identification of the novel narrow-spectrum β-lactamase SCO-1 in Acinetobacter spp. from Argentina. Antimicrob Agents Chemother 51 (2007) 2179-2184
64. Brown S., Young H.K., and Amyes S.G. Characterisation of OXA-51, a novel class D carbapenemase found in genetically unrelated clinical strains of Acinetobacter baumannii from Argentina. Clin Microbiol Infect 11 (2005) 15-23
65. OXA-51-like genes in patients with diabetes mellitus. J Chemother 21 (2009) 290-295
66. Koh T.H., Sng L.H., Wang G.C., Hsu L.Y., and Zhao Y. IMP-4, OXA β-lactamases in Acinetobacter baumannii from Singapore. J Antimicrob Chemother 60 (2007) 1173-1174
67. OXA-51-like carbapenemase gene intrinsic to this species. J Clin Microbiol 44 (2006) 2974-2976
68. Héritier C., Poirel L., Fournier P.E., Claverie J.M., Raoult D., and Nordmann P. Characterization of the naturally occurring oxacillinase of Acinetobacter baumannii. Antimicrob Agents Chemother 49 (2005) 4174-4179
69. Dalla-Costa L.M., Coelho J.M., Souza H.A., Castro M.E., Stier C.J., Bragagnolo K.L., et al. Outbreak of carbapenem-resistant Acinetobacter baumannii producing the OXA-23 enzyme in Curitiba, Brazil. J Clin Microbiol 41 (2003) 3403-3406
70. Jeon B.C., Jeong S.H., Bae I.K., Kwon S.B., Lee K., Young D., et al. Investigation of a nosocomial outbreak of imipenem-resistant Acinetobacter baumannii producing the OXA-23 β-lactamase in Korea. J Clin Microbiol 43 (2005) 2241-2245
71. Naas T., Levy M., Hirschauer C., Marchandin H., and Nordmann P. Outbreak of carbapenem-resistant Acinetobacter baumannii producing the carbapenemase OXA-23 in a tertiary care hospital of Papeete, French Polynesia. J Clin Microbiol 43 (2005) 4826-4829
72. OXA-23 in Acinetobacter baumannii. Antimicrob Agents Chemother 51 (2007) 1530-1533
73. Bou G., Oliver A., and Martínez-Beltrán J. OXA-24, a novel class D β-lactamase with carbapenemase activity in an Acinetobacter baumannii clinical strain. Antimicrob Agents Chemother 44 (2000) 1556-1561
74. Afzal-Shah M., Woodford N., and Livermore D.M. Characterization of OXA-25, OXA-26, and OXA-27, molecular class D β-lactamases associated with carbapenem resistance in clinical isolates of Acinetobacter baumannii. Antimicrob Agents Chemother 45 (2001) 583-588
75. Navia M.M., Ruiz J., and Vila J. Characterization of an integron carrying a new class D β-lactamase (OXA-37) in Acinetobacter baumannii. Microb Drug Resist 8 (2002) 261-265
76. Lopez-Otsoa F., Gallego L., Towner K.J., Tysall L., Woodford N., and Livermore D.M. Endemic carbapenem resistance associated with OXA-40 carbapenemase among Acinetobacter baumannii isolates from a hospital in northern Spain. J Clin Microbiol 40 (2002) 4741-4743
77. Héritier C., Poirel L., Aubert D., and Nordmann P. Genetic and functional analysis of the chromosome-encoded carbapenem-hydrolyzing oxacillinase OXA-40 of Acinetobacter baumannii. Antimicrob Agents Chemother 47 (2003) 268-273
78. Da Silva G.J., Quinteira S., Bértolo E., Sousa J.C., Gallego L., Duarte A., et al. Long-term dissemination of an OXA-40 carbapenemase-producing Acinetobacter baumannii clone in the Iberian Peninsula. J Antimicrob Chemother 54 (2004) 255-258
79. Poirel L., Marqué S., Héritier C., Segonds C., Chabanon G., and Nordmann P. OXA-58, a novel class D β-lactamase involved in resistance to carbapenems in Acinetobacter baumannii. Antimicrob Agents Chemother 49 (2005) 202-208
80. Héritier C., Dubouix A., Poirel L., Marty N., and Nordmann P. A nosocomial outbreak of Acinetobacter baumannii isolates expressing the carbapenem-hydrolysing oxacillinase OXA-58. J Antimicrob Chemother 55 (2005) 115-118
81. Higgins P.G., Poirel L., Lehmann M., Nordmann P., and Seifert H. OXA-143, a novel carbapenem-hydrolyzing class D β-lactamase in Acinetobacter baumannii. Antimicrob Agents Chemother 53 (2009) 5035-5038
82. VIM-2 gene cassettes. J Antimicrob Chemother 49 (2002) 837-840
83. Lee K., Lee W.G., Uh Y., Ha G.Y., Cho J., and Chong Y. VIM- and IMP-type metallo-β-lactamase-producing Pseudomonas spp. and Acinetobacter spp. in Korean hospitals. Emerg Infect Dis 9 (2003) 868-871
84. Tsakris A., Ikonomidis A., Pournaras S., Tzouvelekis L.S., Sofianou D., Legakis N.J., et al. VIM-1 metallo-β-lactamase in Acinetobacter baumannii. Emerg Infect Dis 12 (2006) 981-983
85. Wroblewska M.M., Towner K.J., Marchel H., and Luczak M. Emergence and spread of carbapenem-resistant strains of Acinetobacter baumannii in a tertiary-care hospital in Poland. Clin Microbiol Infect 13 (2007) 490-496
86. Chu Y.W., Afzal-Shah M., Houang E.T., Palepou M.I., Lyon D.J., Woodford N., et al. IMP-4, a novel metallo-β-lactamase from nosocomial Acinetobacter spp. collected in Hong Kong between 1994 and 1998. Antimicrob Agents Chemother 45 (2001) 710-714
87. IMP-5, a new integron-borne metallo-β-lactamase gene from an Acinetobacter baumannii nosocomial isolate in Portugal. FEMS Microbiol Lett 215 (2002) 33-39
88. Gales A.C., Tognim M.C., Reis A.O., Jones R.N., and Sader H.S. Emergence of an IMP-like metallo-enzyme in an Acinetobacter baumannii clinical strain from a Brazilian teaching hospital. Diagn Microbiol Infect Dis 45 (2003) 77-79
89. IMP-4) gene cassettes in class 1 integrons in Acinetobacter strains isolated from blood cultures in 1997 to 2000. Antimicrob Agents Chemother 47 (2003) 1382-1390
90. Zarrilli R., Crispino M., Bagattini M., Barretta E., Di Popolo A., and Triassi M. Molecular epidemiology of sequential outbreaks of Acinetobacter baumannii in an intensive care unit shows the emergence of carbapenem resistance. J Clin Microbiol 42 (2004) 946-953
91. Tognim M.C., Gales A.C., Penteado A.P., Silbert S., and Sader H.S. Dissemination of IMP-1 metallo-β-lactamase-producing Acinetobacter species in a Brazilian teaching hospital. Infect Control Hosp Epidemiol 27 (2006) 742-747
92. SIM-1, in a class 1 integron from Acinetobacter baumannii clinical isolates from Korea. Antimicrob Agents Chemother 49 (2005) 4485-4491
93. Moubareck C., Brémont S., Conroy M.C., Courvalin P., and Lambert T. GES-11, a novel integron-associated GES variant in Acinetobacter baumannii. Antimicrob Agents Chemother 53 (2009) 3579-3581
94. Limansky A.S., Mussi M.A., and Viale A.M. Loss of a 29-kilodalton outer membrane protein in Acinetobacter baumannii is associated with imipenem resistance. J Clin Microbiol 40 (2002) 4776-4778
95. Mussi M.A., Limansky A.S., and Viale A.M. Acquisition of resistance to carbapenems in multidrug-resistant clinical strains of Acinetobacter baumannii: natural insertional inactivation of a gene encoding a member of a novel family of β-barrel outer membrane proteins. Antimicrob Agents Chemother 49 (2005) 1432-1440
96. Siroy A., Molle V., Lemaître-Guillier C., Vallenet D., Pestel-Caron M., Cozzone A.J., et al. Channel formation by CarO, the carbapenem resistance-associated outer membrane protein of Acinetobacter baumannii. Antimicrob Agents Chemother 49 (2005) 4876-4883
97. Gribun A., Nitzan Y., Pechatnikov I., Hershkovits G., and Katcoff D.J. Molecular and structural characterization of the HMP-AB gene encoding a pore-forming protein from a clinical isolate of Acinetobacter baumannii. Curr Microbiol 47 (2003) 434-443
98. Tomás M., Beceiro A., Pérez A., Velasco D., Moure R., Villanueva R., et al. Cloning and functional analysis of the gene encoding the 33- to 36-kilodalton outer membrane protein associated with carbapenem resistance in Acinetobacter baumannii. Antimicrob Agents Chemother 49 (2005) 5172-5175
99. Clark R.B. Imipenem resistance among Acinetobacter baumannii: association with reduced expression of a 33-36 kDa outer membrane protein. J Antimicrob Chemother 38 (1996) 245-251
100. Dupont M., Pagès J.M., Lafitte D., Siroy A., and Bollet C. Identification of an OprD homologue in Acinetobacter baumannii. J Proteome Res 4 (2005) 2386-2390
101. Magnet S., Courvalin P., and Lambert T. Resistance-nodulation-cell division-type efflux pump involved in aminoglycoside resistance in Acinetobacter baumannii strain BM4454. Antimicrob Agents Chemother 45 (2001) 3375-3380
102. Higgins P.G., Wisplinghoff H., Stefanik D., and Seifert H. Selection of topoisomerase mutations and overexpression of adeB mRNA transcripts during an outbreak of Acinetobacter baumannii. J Antimicrob Chemother 54 (2004) 821-823
103. Héritier C., Poirel L., Lambert T., and Nordmann P. Contribution of acquired carbapenem-hydrolyzing oxacillinases to carbapenem resistance in Acinetobacter baumannii. Antimicrob Agents Chemother 49 (2005) 3198-3202
104. Gehrlein M., Leying H., Cullmann W., Wendt S., and Opferkuch W. Imipenem resistance in Acinetobacter baumanii is due to altered penicillin-binding proteins. Chemotherapy 37 (1991) 405-412
105. Fernández-Cuenca F., Martínez-Martínez L., Conejo M.C., Ayala J.A., Perea E.J., and Pascual A. Relationship between β-lactamase production, outer membrane protein and penicillin-binding protein profiles on the activity of carbapenems against clinical isolates of Acinetobacter baumannii. J Antimicrob Chemother 51 (2003) 565-574
106. Guardabassi L., Dijkshoorn L., Collard J.M., Olsen J.E., and Dalsgaard A. Distribution and in-vitro transfer of tetracycline resistance determinants in clinical and aquatic Acinetobacter strains. J Med Microbiol 49 (2000) 929-936
107. Ribera A., Roca I., Ruiz J., Gibert I., and Vila J. Partial characterization of a transposon containing the tet(A) determinant in a clinical isolate of Acinetobacter baumannii. J Antimicrob Chemother 52 (2003) 477-480
108. Huys G., Cnockaert M., Vaneechoutte M., Woodford N., Nemec A., Dijkshoorn L., et al. Distribution of tetracycline resistance genes in genotypically related and unrelated multiresistant Acinetobacter baumannii strains from different European hospitals. Res Microbiol 156 (2005) 348-355
109. Ribera A., Ruiz J., and Vila J. Presence of the Tet M determinant in a clinical isolate of Acinetobacter baumannii. Antimicrob Agents Chemother 47 (2003) 2310-2312
110. Ruzin A., Keeney D., and Bradford P.A. AdeABC multidrug efflux pump is associated with decreased susceptibility to tigecycline in Acinetobacter calcoaceticus-Acinetobacter baumannii complex. J Antimicrob Chemother 59 (2007) 1001-1004
111. Peleg A.Y., Adams J., and Paterson D.L. Tigecycline efflux as a mechanism for non-susceptibility in Acinetobacter baumannii. Antimicrob Agents Chemother 51 (2007) 2065-2069
112. Vila J., Marcos A., Marco F., Abdalla S., Vergara Y., Reig R., et al. In vitro antimicrobial production of β-lactamases, aminoglycoside-modifying enzymes, and chloramphenicol acetyltransferase by and susceptibility of clinical isolates of Acinetobacter baumannii. Antimicrob Agents Chemother 37 (1993) 138-141
113. Nemec A., Dolzani L., Brisse S., van den Broek P., and Dijkshoorn L. Diversity of aminoglycoside-resistance genes and their association with class 1 integrons among strains of pan-European Acinetobacter baumannii clones. J Med Microbiol 53 (2004) 1233-1240
114. +-coupled Acinetobacter baumannii multidrug efflux pump belonging to the MATE family of transporters. Antimicrob Agents Chemother 49 (2005) 4362-4364
115. Yu Y.S., Zhou H., Yang Q., Chen Y.G., and Li L.J. Widespread occurrence of aminoglycoside resistance due to ArmA methylase in imipenem-resistant Acinetobacter baumannii isolates in China. J Antimicrob Chemother 60 (2007) 454-455
116. Doi Y., Adams J.M., Yamane K., and Paterson D.L. Identification of 16S rRNA methylase-producing Acinetobacter baumannii clinical strains in North America. Antimicrob Agents Chemother 51 (2007) 4209-4210
117. Cho Y.J., Moon D.C., Jin J.S., Choi C.H., Lee Y.C., and Lee J.C. Genetic basis of resistance to aminoglycosides in Acinetobacter spp. and spread of armA in Acinetobacter baumannii sequence group 1 in Korean hospitals. Diagn Microbiol Infect Dis 64 (2009) 185-190
118. Lee H., Yong D., Yum J.H., Roh K.H., Lee K., Yamane K., et al. Dissemination of 16S rRNA methylase-mediated highly amikacin-resistant isolates of Klebsiella pneumoniae and Acinetobacter baumannii in Korea. Diagn Microbiol Infect Dis 56 (2006) 305-312
119. Vila J., Ruiz J., Goñi P., and de Anta T.J. Quinolone-resistance mutations in the topoisomerase IV parC gene of Acinetobacter baumannii. J Antimicrob Chemother 39 (1997) 757-762
120. Hamouda A., and Amyes S.G. Novel gyrA and parC point mutations in two strains of Acinetobacter baumannii resistant to ciprofloxacin. J Antimicrob Chemother 54 (2004) 695-696
121. Lee J.K., Lee Y.S., Park Y.K., and Kim B.S. Mutations in the gyrA and parC genes in ciprofloxacin-resistant clinical isolates of Acinetobacter baumannii in Korea. Microbiol Immunol 49 (2005) 647-653
122. Srinivasan V.B., Rajamohan G., and Gebreyes W.A. The role of a novel efflux pump AbeS, member of the SMR family of transporters in resistance to antimicrobial agents in Acinetobacter baumannii. Antimicrob Agents Chemother 53 (2009) 5312-5316
123. Marchand I., Damier-Piolle L., Courvalin P., and Lambert T. Expression of the RND-type efflux pump AdeABC in Acinetobacter baumannii is regulated by the AdeRS two-component system. Antimicrob Agents Chemother 48 (2004) 3298-3304
124. Damier-Piolle L., Magnet S., Brémont S., Lambert T., and Courvalin P. AdeIJK, a resistance-nodulation-cell division pump effluxing multiple antibiotics in Acinetobacter baumannii. Antimicrob Agents Chemother 52 (2008) 557-562
125. Roca I., Marti S., Espinal P., Martínez P., Gibert I., and Vila J. CraA, a major facilitator superfamily efflux pump associated with chloramphenicol resistance in Acinetobacter baumannii. Antimicrob Agents Chemother 53 (2009) 4013-4014
126. Mak J.K., Kim M.J., Pham J., Tapsall J., and White P.A. Antibiotic resistance determinants in nosocomial strains of multidrug-resistant Acinetobacter baumannii. J Antimicrob Chemother 63 (2009) 47-54
127. Adams M.D., Nickel G.C., Bajaksouzian S., Lavender H., Murthy A.R., Jacobs M.R., et al. Resistance to colistin in Acinetobacter baumannii associated with mutations in the PmrAB two-component system. Antimicrob Agents Chemother 53 (2009) 3628-3634
128. Bush K., Jacoby G.A., and Medeiros A.A. A functional classification scheme for β-lactamases and its correlation with molecular structure. Antimicrob Agents Chemother 39 (1995) 1211-1233
129. Giske C.G., Sundsfjord A.S., Kahlmeter G., Woodford N., Nordmann P., Paterson D.L., et al. Redefining extended-spectrum β-lactamases: balancing science and clinical need. J Antimicrob Chemother 63 (2009) 1-4
130. Turton J.F., Ward M.E., Woodford N., Kaufmann M.E., Pike R., Livermore D.M., et al. The role of ISAba1 in expression of OXA carbapenemase genes in Acinetobacter baumannii. FEMS Microbiol Lett 258 (2006) 72-77
131. Poirel L., and Nordmann P. Carbapenem resistance in Acinetobacter baumannii: mechanisms and epidemiology. Clin Microbiol Infect 12 (2006) 826-836
132. Fritsche T.R., Sader H.S., Toleman M.A., Walsh T.R., and Jones R.N. Emerging metallo-β-lactamase-mediated resistances: a summary report from the worldwide SENTRY antimicrobial surveillance program. Clin Infect Dis 15 Suppl. 4 (2005) S276-S278
133. Peleg A.Y., Seifert H., and Paterson D.L. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 21 (2008) 538-582
134. Seward R.J., Lambert T., and Towner K.J. Molecular epidemiology of aminoglycoside resistance in Acinetobacter spp. J Med Microbiol 47 (1998) 455-462
135. Sato K., and Nakae T. Outer membrane permeability of Acinetobacter calcoaceticus and its implication in antibiotic resistance. J Antimicrob Chemother 28 (1991) 35-45
136. Bratu S., Landman D., Martin D.A., Georgescu C., and Quale J. Correlation of antimicrobial resistance with β-lactamases, the OmpA-like porin, and efflux pumps in clinical isolates of Acinetobacter baumannii endemic to New York City. Antimicrob Agents Chemother 52 (2008) 2999-3005
137. Maragakis L.L., and Perl T.M. Acinetobacter baumannii: epidemiology, antimicrobial resistance, and treatment options. Clin Infect Dis 46 (2008) 1254-1263
138. Levin A.S., Levy C.E., Manrique A.E., Medeiros E.A., and Costa S.F. Severe nosocomial infections with imipenem-resistant Acinetobacter baumannii treated with ampicillin/sulbactam. Int J Antimicrob Agents 21 (2003) 58-62
139. Smolyakov R., Borer A., Riesenberg K., Schlaeffer F., Alkan M., Porath A., et al. Nosocomial multi-drug resistant Acinetobacter baumannii bloodstream infection: risk factors and outcome with ampicillin-sulbactam treatment. J Hosp Infect 54 (2003) 32-38
140. Corbella X., Ariza J., Ardanuy C., Vuelta M., Tubau F., Sora M., et al. Efficacy of sulbactam alone and in combination with ampicillin in nosocomial infections caused by multiresistant Acinetobacter baumannii. J Antimicrob Chemother 42 (1998) 793-802
141. Betrosian A.P., Frantzeskaki F., Xanthaki A., and Douzinas E.E. Efficacy and safety of high-dose ampicillin/sulbactam vs. colistin as monotherapy for the treatment of multidrug resistant Acinetobacter baumannii ventilator-associated pneumonia. J Infect 56 (2008) 432-436
142. Lee N.Y., Wang C.L., Chuang Y.C., Yu W.L., Lee H.C., Chang C.M., et al. Combination carbapenem-sulbactam therapy for critically ill patients with multidrug-resistant Acinetobacter baumannii bacteremia: four case reports and an in vitro combination synergy study. Pharmacotherapy 27 (2007) 1506-1511
143. Ko W.C., Lee H.C., Chiang S.R., Yan J.J., Wu J.J., Lu C.L., et al. In vitro and in vivo activity of meropenem and sulbactam against a multidrug-resistant Acinetobacter baumannii strain. J Antimicrob Chemother 53 (2004) 393-395
144. Higgins P.G., Wisplinghoff H., Stefanik D., and Seifert H. In vitro activities of the β-lactamase inhibitors clavulanic acid, sulbactam, and tazobactam alone or in combination with β-lactams against epidemiologically characterized multidrug-resistant Acinetobacter baumannii strains. Antimicrob Agents Chemother 48 (2004) 1586-1592
145. Falagas M.E., and Kasiakou S.K. Colistin: the revival of polymyxins for the management of multidrug-resistant Gram-negative bacterial infections. Clin Infect Dis 40 (2005) 1333-1341
146. Gounden R., Bamford C., van Zyl-Smit R., Cohen K., and Maartens G. Safety and effectiveness of colistin compared with tobramycin for multi-drug resistant Acinetobacter baumannii infections. BMC Infect Dis 9 (2009) 26
147. Linden P.K., and Paterson D.L. Parenteral and inhaled colistin for treatment of ventilator-associated pneumonia. Clin Infect Dis 43 Suppl. 2 (2006) S89-S94
148. Garnacho-Montero J., Ortiz-Leyba C., Jiménez-Jiménez F.J., Barrero-Almodóvar A.E., García-Garmendia J.L., Bernabeu-Wittel I.M., et al. Treatment of multidrug-resistant Acinetobacter baumannii ventilator-associated pneumonia (VAP) with intravenous colistin: a comparison with imipenem-susceptible VAP. Clin Infect Dis 36 (2003) 1111-1118
149. Kwa A.L., Loh C., Low J.G., Kurup A., and Tam V.H. Nebulized colistin in the treatment of pneumonia due to multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa. Clin Infect Dis 41 (2005) 754-757
150. Michalopoulos A., Fotakis D., Virtzili S., Vletsas C., Raftopoulou S., Mastora Z., et al. Aerosolized colistin as adjunctive treatment of ventilator-associated pneumonia due to multidrug-resistant Gram-negative bacteria: a prospective study. Respir Med 102 (2008) 407-412
151. Hawley J.S., Murray C.K., and Jorgensen J.H. Colistin heteroresistance in Acinetobacter and its association with previous colistin therapy. Antimicrob Agents Chemother 52 (2008) 351-352
152. Ko K.S., Suh J.Y., Kwon K.T., Jung S.I., Park K.H., Kang C.I., et al. High rates of resistance to colistin and polymyxin B in subgroups of Acinetobacter baumannii isolates from Korea. J Antimicrob Chemother 60 (2007) 1163-1167
153. Lo-Ten-Foe J.R., de Smet A.M., Diederen B.M., Kluytmans J.A., and van Keulen P.H. Comparative evaluation of the VITEK 2, disk diffusion, Etest, broth microdilution, and agar dilution susceptibility testing methods for colistin in clinical isolates, including heteroresistant Enterobacter cloacae and Acinetobacter baumannii strains. Antimicrob Agents Chemother 51 (2007) 3726-3730
154. Markou N., Markantonis S.L., Dimitrakis E., Panidis D., Boutzouka E., and Karatzas S. Colistin serum concentrations after intravenous administration in critically ill patients with serious multidrug-resistant, Gram-negative bacilli infections: a prospective, open-label, uncontrolled study. Clin Ther 30 (2008) 143-151
155. Ellis-Grosse E., Babinchak T., Dartois N., Rose G., and Loh E. The efficacy and safety of tigecycline in the treatment of skin and skin-structure infections: results of 2 double-blind phase 3 comparison studies with vancomycin-aztreonam. Clin Infect Dis 41 Suppl. 5 (2005) S341-S353
156. Oliva M., Rekha A., Yellin A., Pasternak J., Camos M., Rose G.M., et al. A multicenter trial of the efficacy and safety of tigecycline versus imipenem/cilastatin in patients with complicated intra-abdominal infections. BMC Infect Dis 5 (2005) 88 [Study ID Numbers: 3074A1-301-WW; ClinicalTrials.gov Identifier: NCT00081744]
157. Gordon N.C., and Wareham D.W. A review of clinical and microbiological outcomes following treatment of infections involving multidrug-resistant Acinetobacter baumannii with tigecycline. J Antimicrob Chemother 63 (2009) 775-780
158. Schafer J., Goff D., Stevenson K., and Mangino J.E. Early experience with tigecycline for ventilator-associated pneumonia and bacteraemia caused by multidrug-resistant Acinetobacter baumannii. Pharmacotherapy 27 (2007) 980-987
159. Peleg A.Y., Potoski B.A., Rea R., Adams J., Sethi J., Capitano B., et al. Acinetobacter baumannii bloodstream infection while receiving tigecycline: a cautionary report. J Antimicrob Chemother 59 (2007) 128-131
160. Petrosillo N., Ioannidou E., and Falagas M.E. Colistin monotherapy vs. combination therapy: evidence from microbiological, animal and clinical studies. Clin Microbiol Infect 14 (2008) 816-827
161. Bernabeu-Wittel M., Pichardo C., García-Curiel A., Pachón-Ibáñez M.E., Ibáñez-Martínez J., Jiménez-Mejías M.E., et al. Pharmacokinetic/pharmacodynamic assessment of the in-vivo efficacy of imipenem alone or in combination with amikacin for the treatment of experimental multiresistant Acinetobacter baumannii pneumonia. Clin Microbiol Infect 11 (2005) 319-325
162. Saballs M., Pujol M., Tubau F., Peña C., Montero A., and Domínguez M.A. Rifampicin/imipenem combination in the treatment of carbapenem-resistant Acinetobacter baumannii infections. J Antimicrob Chemother 58 (2006) 697-700
163. Principe L., D'Arezzo S., Capone A., Petrosillo N., and Visca P. In vitro activity of tigecycline in combination with various antimicrobials against multidrug resistant Acinetobacter baumannii. Ann Clin Microbiol Antimicrob 8 (2009) 18