Evolution, control and success of combination therapy with Ampicilin-sulbactam/Ceftazidime-Avibactam during a Carbapenem-Resistant Acinetobacter baumannii outbreak in burn Intensive Care Unit

Emmanuel Dudoignon; Francois Caméléna; Matthieu Lafaurie; Benjamin Deniau; Maité Chaussard; Maxime Coutrot; Lucie Guillemet; Alexandru Cupaciu; Alexandre Pharaboz; Louis Boutin; Mourad Benyamina; Marc Chaouat; Maurice Mimoun; Manel Merimèche; Alexandre Mebazaa; Benoit Plaud; Béatrice Berçot; François Dépret; Guillaume Mellon

doi:10.1007/s10096-024-04840-9

Evolution, control and success of combination therapy with Ampicilin-sulbactam/Ceftazidime-Avibactam during a Carbapenem-Resistant Acinetobacter baumannii outbreak in burn Intensive Care Unit

Eur J Clin Microbiol Infect Dis. 2024 Jul;43(7):1453-1459. doi: 10.1007/s10096-024-04840-9. Epub 2024 Apr 27.

Authors

Emmanuel Dudoignon^{1

2

3

4

5}, Francois Caméléna^{6

7

8}, Matthieu Lafaurie⁹, Benjamin Deniau^{10

6

11

12

13}, Maité Chaussard¹⁰, Maxime Coutrot¹⁰, Lucie Guillemet¹⁰, Alexandru Cupaciu¹⁰, Alexandre Pharaboz¹⁰, Louis Boutin^{10

6

11}, Mourad Benyamina¹⁰, Marc Chaouat^{6

14}, Maurice Mimoun^{6

14}, Manel Merimèche^{7

8}, Alexandre Mebazaa^{10

6

11

12

13}, Benoit Plaud^{10

6

11

13}, Béatrice Berçot^{6

7

8}, François Dépret^{10

6

11

12

13}, Guillaume Mellon^{15

16}

Affiliations

¹ Department of Anesthesiology and Critical Care and Burn Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier St Louis- Lariboisière, 1, avenue Claude Vellefaux, Paris, 75010, France. emmanuel.dudoignon@aphp.fr.
² University of Paris Cité, Paris, France. emmanuel.dudoignon@aphp.fr.
³ Institut National de la Santé et de la Recherche Médicale (INSERM), INSERM UMR-S 942 Mascot, Lariboisière Hospital, Paris, France. emmanuel.dudoignon@aphp.fr.
⁴ INI-CRCT Network, Nancy, France. emmanuel.dudoignon@aphp.fr.
⁵ FHU PROMICE, Paris, France. emmanuel.dudoignon@aphp.fr.
⁶ University of Paris Cité, Paris, France.
⁷ Department of Bacteriology, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier St Louis-Lariboisière, Paris, France.
⁸ INSERM 1137, IAME, Paris, France.
⁹ Infectious Diseases Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Paris, France.
¹⁰ Department of Anesthesiology and Critical Care and Burn Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier St Louis- Lariboisière, 1, avenue Claude Vellefaux, Paris, 75010, France.
¹¹ Institut National de la Santé et de la Recherche Médicale (INSERM), INSERM UMR-S 942 Mascot, Lariboisière Hospital, Paris, France.
¹² INI-CRCT Network, Nancy, France.
¹³ FHU PROMICE, Paris, France.
¹⁴ Plastic Surgery, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Paris, France.
¹⁵ Infectious Disease Prevention and Control Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Paris, France.
¹⁶ DMU PRISME, Paris, France.

PMID: 38676856
DOI: 10.1007/s10096-024-04840-9

Abstract

We present our findings on interpatient transmission, epidemic control measures, and the outcomes of a series of ten critically ill burn patients who were either colonized or infected with carbapenem-resistant Acinetobacter baumannii (CRAB). None of the five infected patients achieved clinical cure, and all experienced relapses. Microbiological failure was observed in 40% of the infected patients. The isolated CRAB strains were found to carry bla_OXA-23 and armA resistance genes. Despite the lack of clinical cure, all five infected patients survived and were discharged from the Burn Intensive Care Unit.

Keywords: Ampicillin-sulbactam; Antibiotic resistance; Burn; Carbapenem-resistant Acinetobacter baumannii; Cefiderocol; Outbreak; Whole-genome sequencing.

MeSH terms

Acinetobacter Infections* / drug therapy
Acinetobacter Infections* / epidemiology
Acinetobacter Infections* / microbiology
Acinetobacter baumannii* / drug effects
Acinetobacter baumannii* / genetics
Acinetobacter baumannii* / isolation & purification
Adult
Aged
Anti-Bacterial Agents* / pharmacology
Anti-Bacterial Agents* / therapeutic use
Azabicyclo Compounds* / pharmacology
Azabicyclo Compounds* / therapeutic use
Burn Units
Burns / complications
Burns / microbiology
Carbapenems* / pharmacology
Carbapenems* / therapeutic use
Ceftazidime* / pharmacology
Ceftazidime* / therapeutic use
Cross Infection / drug therapy
Cross Infection / epidemiology
Cross Infection / microbiology
Disease Outbreaks*
Drug Combinations*
Drug Resistance, Multiple, Bacterial / genetics
Drug Therapy, Combination
Female
Humans
Intensive Care Units*
Male
Middle Aged
Sulbactam* / pharmacology
Sulbactam* / therapeutic use
Treatment Outcome
beta-Lactamases / genetics

Substances

Anti-Bacterial Agents
Azabicyclo Compounds
Sulbactam
Drug Combinations
Carbapenems
Ceftazidime
avibactam, ceftazidime drug combination
beta-Lactamases