Rapid acquisition and modulation of colistin-resistance by an extensively drug-resistant Acinetobacter baumannii: case report and review of current literature


Submitted: 7 March 2016
Accepted: 2 May 2016
Published: 18 October 2016
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Acinetobacter baumannii has emerged as a major cause of healthcare-associated infections. It commonly expresses clinical resistance to multiple antimicrobial agents, and hence, it is considered the paradigm of an extensively drug-resistant (XDR) bacterium. XDR A. baumannii is a rapidly emerging pathogen, especially in the intensive care unit (ICU), causing nosocomial infections including sepsis, ventilatorassociated pneumonia, meningitis, peritonitis, urinary tract infection, and central venous catheter-related infection. In the present report, we described an in vivo evolution of A. baumannii strain from a colistinsusceptibility to a colistin-resistance state. A 65-year-old male, who suffered a duodenal ulcer, two days after hospitalization and during the stay in ICU, contracted a pneumonia and peritoneal infection by a carbapenem-resistant A. baumannii strain. After a combination treatment with colistin, vancomycin plus imipenem, and within seven days, the pathogen rapidly evolved in seven days to a pandrug-resistant phenotype. As the antimicrobial treatment was stopped, the A. baumannii isolate changed another time its profile to colistin, becoming newly susceptible, showing a very high level of adaptability to external conditions. We also have reviewed here the current literature on this worryingly public health threat.

Intra, J., Sala, R. M., Beck, E., & Brambilla, P. (2016). Rapid acquisition and modulation of colistin-resistance by an extensively drug-resistant Acinetobacter baumannii: case report and review of current literature. Microbiologia Medica, 31(3). https://doi.org/10.4081/mm.2016.5869

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