Indications of carbapenem resistance evolution through heteroresistance as an intermediate stage in Acinetobacter baumannii after carbapenem administration

Rev Inst Med Trop Sao Paulo. 2009 Mar-Apr;51(2):111-3. doi: 10.1590/s0036-46652009000200010.

Abstract

We describe an in vivo evolution of an antimicrobial profile from susceptibility to full-resistance to carbapenems, with heteroresistance as an intermediate stage, in an Acinetobacter baumannii strain. Heteroresistance was characterized by the growth of sub-populations within the susceptibility halo in both disk-diffusion and Etest. PCRs for the main A. baumannii carbapenemases were negative. The exact resistance mechanism, diagnostic methods and clinical relevance of heteroresistance in A. baumannii warrant further investigations. This is the first description of such phenomenon in vivo and the second report of heteroresistance to carbapenems in A. baumannii.

Publication types

  • Case Reports

MeSH terms

  • Acinetobacter Infections / drug therapy
  • Acinetobacter Infections / microbiology*
  • Acinetobacter baumannii / drug effects*
  • Aged
  • Anti-Bacterial Agents / pharmacology*
  • Disk Diffusion Antimicrobial Tests
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Humans
  • Imipenem / pharmacology*
  • Imipenem / therapeutic use
  • Meropenem
  • Phenotype
  • Thienamycins / pharmacology*
  • Thienamycins / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Thienamycins
  • Imipenem
  • Meropenem