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Differences in Colistin-resistant Acinetobacter baumannii Clinical Isolates Between Patients With and Without Prior Colistin Treatment.

DC Field Value Language
dc.contributor.author김도균-
dc.contributor.author용동은-
dc.contributor.author이혁민-
dc.contributor.author정석훈-
dc.contributor.author홍준성-
dc.date.accessioned2018-11-16T16:40:26Z-
dc.date.available2018-11-16T16:40:26Z-
dc.date.issued2018-
dc.identifier.issn2234-3806-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/165209-
dc.description.abstractBACKGROUND: The increasing morbidity and mortality rates associated with Acinetobacter baumannii are due to the emergence of drug resistance and the limited treatment options. We compared characteristics of colistin-resistant Acinetobacter baumannii (CR-AB) clinical isolates recovered from patients with and without prior colistin treatment. We assessed whether prior colistin treatment affects the resistance mechanism of CR-AB isolates, mortality rates, and clinical characteristics. Additionally, a proper method for identifying CR-AB was determined. METHODS: We collected 36 non-duplicate CR-AB clinical isolates resistant to colistin. Antimicrobial susceptibility testing, Sanger sequencing analysis, molecular typing, lipid A structure analysis, and in vitro synergy testing were performed. Eleven colistin-susceptible AB isolates were used as controls. RESULTS: Despite no differences in clinical characteristics between patients with and without prior colistin treatment, resistance-causing genetic mutations were more frequent in isolates from colistin-treated patients. Distinct mutations were overlooked via the Sanger sequencing method, perhaps because of a masking effect by the colistin-susceptible AB subpopulation of CR-AB isolates lacking genetic mutations. However, modified lipid A analysis revealed colistin resistance peaks, despite the population heterogeneity, and peak levels were significantly different between the groups. CONCLUSIONS: Although prior colistin use did not induce clinical or susceptibility differences, we demonstrated that identification of CR-AB by sequencing is insufficient. We propose that population heterogeneity has a masking effect, especially in colistin non-treated patients; therefore, accurate testing methods reflecting physiological alterations of the bacteria, such as phosphoethanolamine-modified lipid A identification by matrix-assisted laser desorption ionization-time of flight, should be employed.-
dc.description.statementOfResponsibilityopen-
dc.formatapplication/pdf-
dc.languageEnglish-
dc.publisherKorean Society for Laboratory Medicine-
dc.relation.isPartOfANNALS OF LABORATORY MEDICINE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAcinetobacter Infections/drug therapy*-
dc.subject.MESHAcinetobacter Infections/microbiology-
dc.subject.MESHAcinetobacter baumannii/drug effects-
dc.subject.MESHAcinetobacter baumannii/isolation & purification*-
dc.subject.MESHAdolescent-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAnti-Bacterial Agents/therapeutic use*-
dc.subject.MESHAnti-Infective Agents/pharmacology-
dc.subject.MESHColistin/therapeutic use*-
dc.subject.MESHDNA, Bacterial/genetics-
dc.subject.MESHDNA, Bacterial/metabolism-
dc.subject.MESHDrug Resistance, Bacterial/genetics-
dc.subject.MESHElectrophoresis, Gel, Pulsed-Field-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHLipid A/analysis-
dc.subject.MESHLipid A/chemistry-
dc.subject.MESHMale-
dc.subject.MESHMicrobial Sensitivity Tests-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMultilocus Sequence Typing-
dc.subject.MESHSpectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization-
dc.subject.MESHYoung Adult-
dc.titleDifferences in Colistin-resistant Acinetobacter baumannii Clinical Isolates Between Patients With and Without Prior Colistin Treatment.-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Laboratory Medicine (진단검사의학교실)-
dc.contributor.googleauthorYu Jin Park-
dc.contributor.googleauthorDuck Jin Hong-
dc.contributor.googleauthorEun-Jeong Yoon-
dc.contributor.googleauthorDokyun Kim-
dc.contributor.googleauthorMin Hyuk Choi-
dc.contributor.googleauthorJun Sung Hong-
dc.contributor.googleauthorHyukmin Lee-
dc.contributor.googleauthorDongeun Yong-
dc.contributor.googleauthorSeok Hoon Jeong-
dc.identifier.doi10.3343/alm.2018.38.6.545-
dc.contributor.localIdA04891-
dc.contributor.localIdA02423-
dc.contributor.localIdA03286-
dc.contributor.localIdA03619-
dc.relation.journalcodeJ00164-
dc.identifier.eissn2234-3814-
dc.identifier.pmid30027698-
dc.subject.keywordAcinetobacter baumannii-
dc.subject.keywordColistin-
dc.subject.keywordLipid A analysis-
dc.subject.keywordPathogenesis-
dc.subject.keywordPopulation heterogeneity-
dc.subject.keywordResistance-
dc.contributor.alternativeNameKim, Dokyun-
dc.contributor.alternativeNameYong, Dong Eun-
dc.contributor.alternativeNameLee, Hyuk Min-
dc.contributor.alternativeNameJeong, Seok Hoon-
dc.contributor.affiliatedAuthor김도균-
dc.contributor.affiliatedAuthor용동은-
dc.contributor.affiliatedAuthor이혁민-
dc.contributor.affiliatedAuthor정석훈-
dc.citation.volume38-
dc.citation.number6-
dc.citation.startPage545-
dc.citation.endPage554-
dc.identifier.bibliographicCitationANNALS OF LABORATORY MEDICINE, Vol.38(6) : 545-554, 2018-
dc.identifier.rimsid58627-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers

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