Review
Version 1
Preserved in Portico This version is not peer-reviewed
A Systematic Review of Implications, Mechanisms, and Stability of In Vivo Emergent Resistance to Colistin and Tigecycline in Acinetobacter baumannii
Version 1
: Received: 12 June 2020 / Approved: 14 June 2020 / Online: 14 June 2020 (14:16:40 CEST)
A peer-reviewed article of this Preprint also exists.
Abstract
The potential of A. baumannii for acquired resistance to last resort antibiotics (colistin and tigecycline) during treatment has important clinical implications, especially when dealing with patients failing to improve despite treatment with an active antimicrobial. However, the relevant literature remains scattered. Therefore, a systematic search was conducted in PubMed and Scopus. Several studies reported emergence of resistance to colistin or tigecycline during treatment, in most cases (86%) resulting in persistent or recurrent infections, especially in cases of emergent resistance without fitness cost. Lipopolysaccharide modification in the case of colistin and overexpression of efflux pumps in the case of tigecycline were the main mechanisms of resistance. Emergent colistin resistance is often associated with fitness cost resulting in re-emergence of the fitter and more virulent colistin susceptible strain after cessation of antibiotic pressure. Prospective studies are needed to determine the frequency of emergent resistance during treatment and its impact on patient outcomes.
Keywords
Acinetobacter baumannii; colistin; tigecycline; resistance; in vivo
Subject
Medicine and Pharmacology, Pharmacy
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Comments (0)
We encourage comments and feedback from a broad range of readers. See criteria for comments and our Diversity statement.
Leave a public commentSend a private comment to the author(s)
* All users must log in before leaving a comment
