Comparison of Hypervirulent and Non-Hypervirulent Carbapenem-Resistant Acinetobacter baumannii Isolated from Bloodstream Infections: Mortality, Potential Virulence Factors, and Combination Therapy In Vitro
Abstract
:1. Introduction
2. Results
2.1. General Characteristics of CRAB-BSI
2.2. Grouping of CRAB-BSI and ST Type
2.3. Differences in Clinical Characteristics between Hv-CRAB-BSI and Non-Hv-CRAB-BSI
2.4. Differences in Toxome between Hv-CRAB-BSI and Non-Hv-CRAB-BSI
2.5. Differences in Resistome between Hv-CRAB-BSI and Non-Hv-CRAB-BSI
2.6. Differences in Antimicrobial Susceptibility and Synergistic Effect between Hv-CRAB-BSI and Non-Hv-CRAB-BSI
3. Discussion
4. Materials and Methods
4.1. Strains and Ethics
4.2. Galleria mellonella Infection Model and Grouping
4.3. Whole-Genome Sequencing (WGS) and Bioinformatic Analysis
4.4. Antimicrobial Susceptibility Testing
4.5. Checkerboard Broth Microdilution
4.6. Statistical Analysis
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Total (n = 31) | Groups | p-Value | |
---|---|---|---|---|
Hv-CRAB-BSI (n = 24) | Non-hv-CRAB-BSI (n = 7) | |||
Age (yr, X ± S) | 63.5 ± 20.7 | 63.7 ± 20.4 | 63.0 ± 23.3 | 0.94 |
Sex at birth, Male | 25 (80.6%) | 20 (83.3%) | 5 (71.4%) | 0.59 |
ICU admission | 28 (90.3%) | 23 (95.8%) | 5 (71.4%) | 0.12 |
Combined underlying disease | 21 (67.7%) | 15 (62.5%) | 6 (85.7%) | 0.379 |
Hypertension | 14 (45.2%) | 11 (45.8%) | 3 (42.9%) | 1 |
Diabetes | 7 (22.6%) | 6 (25.0%) | 1 (14.3%) | 1 |
Coronary artery disease | 12 (38.7%) | 9 (37.5%) | 3 (42.9%) | 1 |
Cerebral hemorrhage | 6 (19.4%) | 6 (25.0%) | 0 (0.0%) | 0.293 |
COPD # | 3 (9.7%) | 3 (12.5%) | 0 (0.0%) | 1 |
Invasive operation | 24 (77.4%) | 20 (83.3%) | 4 (57.1%) | 0.302 |
Peripherally inserted central catheter | 20 (64.5%) | 17 (70.8%) | 3 (42.9%) | 0.21 |
Tracheal intubation and tracheotomy | 22 (71.0%) | 18 (75.0%) | 4 (57.1%) | 0.384 |
Catheter | 20 (64.5%) | 18 (75.0%) | 2 (28.6%) | 0.067 |
Gastric intubation | 20 (64.5%) | 18 (75.0%) | 2 (28.6%) | 0.067 |
Thoracic and abdominal drainage tube | 8 (25.8%) | 8 (33.3%) | 0 (0.0%) | 0.146 |
Septic shock | 20 (64.5%) | 19 (79.2%) | 1 (14.3%) | 0.004 |
Clinical outcome | ||||
Death | 17 (54.8%) | 16 (66.7%) | 1 (14.3%) | 0.028 |
Recover | 14 (45.2%) | 8 (33.3%) | 6 (85.7%) |
Antimicrobial Agents | Resistance Rate (%) | p-Value * | Resistance Rate (%) | MIC50 (mg/L) | MIC90 (mg/L) | |
---|---|---|---|---|---|---|
Hv-CRAB-BSI (n = 24) | Non-hv-CRAB-BSI (n = 7) | Total (n = 31) | ||||
Imipenem | 24 (100) | 7 (100) | - | 31 (100) | 64 | 128 |
Meropenem | 24 (100) | 7 (100) | - | 31 (100) | 64 | 128 |
Ceftriaxone | 24 (100) | 7 (100) | - | 31 (100) | 128 | 128 |
Ceftazidime | 24 (100) | 7 (100) | - | 31 (100) | 128 | 128 |
Cefepime | 24 (100) | 7 (100) | - | 31 (100) | 128 | 128 |
Cefoperazone/sulbactam | 24 (100) | 6 (85.7) | 0.226 | 30 (96.7) | 128 | 128 |
Tigecycline | 5 (20.8) | 3 (42.9) | 0.335 | 8 (25.8) | 4 | 8 |
Minocycline | 13 (54.2) | 7 (100) | 0.033 | 20 (64.5) | 16 | 32 |
Colistin | 0 (0) | 0 (0) | - | 0 (0) | 0.5 | 1 |
Ampicillin/sulbactam | 24 (100) | 7 (100) | - | 31 (100) | 128/64 | 128/64 |
Piperacillin/tazobactam | 24 (100) | 7 (100) | - | 31 (100) | 128/4 | 128/4 |
Levofloxacin | 24 (100) | 7 (100) | - | 31 (100) | 16 | 64 |
Ciprofloxacin | 24 (100) | 7 (100) | - | 31 (100) | 8 | 8 |
Gentamycin | 24 (100) | 5 (71.4) | 0.045 | 29 (93.5) | 64 | 64 |
Amikacin | 20 (83.3) | 5 (71.4) | 0.596 | 25 (80.6) | 128 | 128 |
Tobramycin | 17 (70.8) | 7 (100) | 0.161 | 24 (77.4) | 16 | 64 |
Trimethoprim/sulfamethoxazole | 24 (100) | 7 (100) | - | 31 (100) | 16/304 | 32/608 |
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Yao, L.; Liu, N.; Guo, Y.; Zhuo, C.; Yang, X.; Wang, Y.; Wang, J.; Li, F.; Li, J.; He, N.; et al. Comparison of Hypervirulent and Non-Hypervirulent Carbapenem-Resistant Acinetobacter baumannii Isolated from Bloodstream Infections: Mortality, Potential Virulence Factors, and Combination Therapy In Vitro. Antibiotics 2024, 13, 807. https://doi.org/10.3390/antibiotics13090807
Yao L, Liu N, Guo Y, Zhuo C, Yang X, Wang Y, Wang J, Li F, Li J, He N, et al. Comparison of Hypervirulent and Non-Hypervirulent Carbapenem-Resistant Acinetobacter baumannii Isolated from Bloodstream Infections: Mortality, Potential Virulence Factors, and Combination Therapy In Vitro. Antibiotics. 2024; 13(9):807. https://doi.org/10.3390/antibiotics13090807
Chicago/Turabian StyleYao, Likang, Ningjing Liu, Yingyi Guo, Chuyue Zhuo, Xu Yang, Yijing Wang, Jiong Wang, Feifeng Li, Jiahui Li, Nanhao He, and et al. 2024. "Comparison of Hypervirulent and Non-Hypervirulent Carbapenem-Resistant Acinetobacter baumannii Isolated from Bloodstream Infections: Mortality, Potential Virulence Factors, and Combination Therapy In Vitro" Antibiotics 13, no. 9: 807. https://doi.org/10.3390/antibiotics13090807