Breakpoints #99 – Don’t be CRABby: Acinetobacter baumannii review
Jun 28, 2024
Dr. Yohei Doi, a leading expert in antimicrobial resistance from the University of Pittsburgh, and Dr. Emily Heil, a professor and antimicrobial stewardship coordinator at the University of Maryland, discuss the complexities of treating Acinetobacter baumannii, particularly its carbapenem-resistant form (CRAB). They highlight innovative treatment options, including promising drug combinations, and delve into the challenges faced in clinical practice. Real-world experiences and research insights offer listeners a nuanced understanding of this formidable pathogen.
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Acinetobacter's Resistance Mechanisms
- Acinetobacter baumannii's resistance is driven by its genome plasticity enabling gene uptake and shedding.
- Its strong adaptation to healthcare antibiotic pressures contributes to its extensive drug resistance.
Carbapenem Resistance Enzymes
- Most carbapenem-resistant Acinetobacter globally carry OXA-23 carbapenemase.
- Carbapenem resistance is fairly uniform worldwide due to acquired oxacarbapenemase enzymes.
Distinguishing Infection from Colonization
- Distinguish infection from colonization by correlating clinical signs with culture results.
- Avoid treating non-infected colonization, especially in respiratory specimens with stable clinical status.