{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T02:54:21Z","timestamp":1785207261148,"version":"3.55.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>In COVID-19 patients on mechanical ventilation, VAP from <jats:italic>Acinetobacter baumannii<\/jats:italic> remains a crucial risk factor for death. Antibiotic resistance represents an important problem in treating this infection. This study aims to describe the evolution of the superinfection from <jats:italic>PDR Acinetobacter baumannii<\/jats:italic> in patients with acute respiratory failure from SARS-CoV-2 infection admitted to ICU and compare the impact of two different antibiotic strategies on microbiological negativization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:italic>S<\/jats:italic>ingle-center observational retrospective study, including patients admitted to our ICU from March 2020 to May 2021 for acute respiratory failure from SARS-CoV-2 infection who developed <jats:italic>PDR Acinetobacter baumannii<\/jats:italic> superinfection. Clinical data at ICU admission were collected, as well as the timing of isolation of <jats:italic>Acinetobacter baumannii<\/jats:italic>, its resistance profile, the site of infection, and the antibiotic therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 32 patients enrolled, 10 patients (31.2%) were treated with the combination of high-dose ampicillin\/sulbactam, high-dose tigecycline, intravenous and inhaled colistin <jats:italic>(Protocol)<\/jats:italic>, the other 22 (68.8%) were treated with the combination of two antibiotics <jats:italic>(Control)<\/jats:italic>. Of the 10 patients in the <jats:italic>Protocol<\/jats:italic> group, 8 patients (80%) received also fosfomycin. All patients (100%) in the <jats:italic>Protocol<\/jats:italic> group had microbiological negativization, while in the <jats:italic>Control<\/jats:italic> group microbiological negativization was observed in 8 (36.4%) patients, <jats:italic>p<\/jats:italic> &amp;lt; 0.01.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our report shows microbiological negativization in all patients treated with the combination therapy of nebulized and intravenous colistin, high-dose tigecycline, and high-dose ampicillin\/sulbactam. This combination of antibiotics seems to be a useful alternative when other treatments are not available or fail.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.910031","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T06:45:31Z","timestamp":1654238731000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Antibiotic Treatment of Acinetobacter baumannii Superinfection in Patients With SARS-CoV-2 Infection Admitted to Intensive Care Unit: An Observational Retrospective 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