{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T07:34:41Z","timestamp":1778312081678,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2010,9,13]],"date-time":"2010-09-13T00:00:00Z","timestamp":1284336000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:p>Objectives: Carbapenem-resistant (CR) Acinetobacter baumannii is an important pathogen in ventilator-associated pneumonia (VAP), but therapeutic options are limited. We describe the clinical outcomes of the largest case series of CR-Acinetobacter VAP reported to date. Methods: A retrospective analysis of 55 participants with CR-Acinetobacter VAP from July 2004 to December 2007 was undertaken. The primary endpoint was clinical response or microbiological eradication. Secondary endpoint was treatment-associated nephrotoxicity defined as \u226550% increase in serum creatinine or an increase of \u22650.5 mg\/dL during therapy. Results: Forty-two (76.4%) participants achieved clinical response at the completion of therapy. Clinical responses were achieved in 60.0% of sulbactam-based, 66.7% of polymyxin-based, 77.8% of aminoglycoside-based, 80.6% of minocycline-based, and 90.0% of tigecycline-based regimens. Follow-up sputum cultures were available in 6 of 10 tigecycline-treated participants with 4 of 6 isolates developing intermediate resistance to tigecycline while on therapy. Ten (18.2%) participants without preexisting renal disease developed treatment-associated nephrotoxicity. Baseline serum creatinine was 0.9 \u00b1 0.1 mg\/dL (range: 0.6-1.0 mg\/dL) at the start of therapy and peaked at 1.9 \u00b1 0.5 mg\/dL (range: 1.6-3.0 mg\/dL) during therapy. After excluding other potential concomitant renal toxic agents, nephrotoxicity developed in 6 of 30 (20.0%) and 4 of 7 (57.1%) participants treated with an aminoglycoside-or polymyxin-based regimen, respectively. Conclusions: Our results demonstrated that CR-Acinetobacter VAP can be effectively treated with second-line agents. However, colistin-related nephrotoxicity was much higher than recently reported and decreased susceptibility to tigecycline emerged on therapy demonstrating the limitations of alternative regimens.<\/jats:p>","DOI":"10.1177\/0885066610377975","type":"journal-article","created":{"date-parts":[[2010,9,14]],"date-time":"2010-09-14T00:10:48Z","timestamp":1284423048000},"page":"343-348","source":"Crossref","is-referenced-by-count":71,"title":["Antimicrobial Treatment and Clinical Outcomes of Carbapenem-Resistant Acinetobacter baumannii Ventilator-Associated Pneumonia"],"prefix":"10.1177","volume":"25","author":[{"given":"Jeannie D.","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Harborview Medical Center, and School of Pharmacy, University of Washington, Seattle, WA, USA,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph A.","family":"Graves","sequence":"additional","affiliation":[{"name":"Howard University College of Medicine, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy H.","family":"Dellit","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Allergy & Infectious Diseases, Harborview Medical Center and School of Medicine, University of Washington, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2010,9,13]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200405-644ST"},{"key":"atypb2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-1116"},{"key":"atypb3","doi-asserted-by":"publisher","DOI":"10.1086\/529198"},{"key":"atypb4","doi-asserted-by":"publisher","DOI":"10.1086\/429323"},{"key":"atypb5","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-003-1811-2"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkn165"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.1086\/340055"},{"key":"atypb8","doi-asserted-by":"publisher","DOI":"10.1080\/00365540600951184"},{"issue":"6","key":"atypb9","first-page":"432","volume":"56","author":"Betrosian AP","year":"2008","journal-title":"Acinetobacter baumannii. ventilator-associated pneumonia. 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