期刊
INFECTION AND DRUG RESISTANCE
卷 15, 期 -, 页码 2401-2408出版社
DOVE MEDICAL PRESS LTD
DOI: 10.2147/IDR.S357344
关键词
CRAB; minocycline PK-PD non-susceptibility; multidrug resistance; efflux
资金
- Ministry of Science and Technology, Taiwan [MOST-109-2628-B-00-041, MOST-109-2314-B-002-235-MY3]
- National Taiwan University Hospital [NTUH.110-S4901]
- Far Eastern Memorial Hospital
- National Taiwan University Hospital Joint Research Program [108-FTN14, 109-FTN09, 110-FTN10]
This study evaluated the susceptibility of carbapenem-resistant Acinetobacter baumannii (CRAB) clinical strains to minocycline, and found a significant correlation between tetB carriage and minocycline susceptibility in CRAB.
Purpose: In this study, we evaluated the minocycline susceptibility rate in carbapenem-resistant Acinetobacter baumannii (CRAB) clinical strains, and the association between tetB carriage and minocycline susceptibility in CRAB. Patients and Methods: A total of 100 genetically unrelated CRAB clinical strains from bloodstream infection were randomly collected from a medical center in Taiwan. An argument for a new minocycline susceptibility breakpoint of 1 mg/L was suggested based on pharmacokinetic (PK) and pharmacodynamic (PD) studies. Strains with minocycline minimum inhibitory concentrations (MICs) of >1 mg/L were classified as PK-PD non-susceptible. TetB carriage was detected by polymerase chain reaction (PCR). Results: Fifty-five (55%) CRAB strains were susceptible to minocycline according to the Clinical and Laboratory Standards Institute (CLSI) criteria, among which 98.2% (54/55) were PK-PD non-susceptible. The minocycline MIC50/90 was 4/16 mg/L. Ninety-seven (97%) strains carried tetB. All of the tetB-positive strains and 66.7% (2/3) of the tetB-negative strains were PK-PD non-susceptible. By statistical analysis, tetB carriage was significantly correlated with PK-PD non-susceptibility (P = 0.03) and a higher minocycline MIC (P = 0.02). The sensitivity and specificity of the tetB PCR for predicting PK-PD non-susceptibility were 98% and 100%, respectively. Conclusion: At our institute, most CRAB strains were PK-PD non-susceptible and most carried tetB gene. Recognizing the minocycline MIC and tetB status may be essential when using minocycline to treat CRAB-related infections.
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