ArticleJournal of biomedical science2023
Multiple heteroresistance to tigecycline and colistin in Acinetobacter baumannii isolates and its implications for combined antibiotic treatment.
Article in Journal of biomedical science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Global trends and research profile of antibiotic heteroresistance: a bibliometric and visual analysis.Frontiers in microbiology · 2026Pooled it
- Dual population-level processes contribute to polyclonal ceftiofur heteroresistance in swine-derivedVirulence · 2026Article
- Beyond susceptibility results: understanding the clinical and diagnostic burden of bacterial heteroresistance.Molecular biology reports · 2026Review
- Beyond minimum inhibitory concentration values: clinical and diagnostic challenges of colistin heteroresistance in Acinetobacter baumannii.Molecular biology reports · 2026Review
- Precision Approaches to Carbapenem-Resistant Infections in the ICU: Integrating Diagnostics, Stewardship, and Novel Therapies.Diagnostics (Basel, Switzerland) · 2026Review
- Assessment of Eravacycline Antimicrobial Susceptibility in China During the First Year Following Regulatory Approval (2023-2024): A Real-World Study.Microorganisms · 2025Article
- Resistance in gram-negative bacilli: the emergence of RND efflux pumps.Future microbiology · 2025Review
- Overview of heteroresistance to multiple antibiotics in clinicalJAC-antimicrobial resistance · 2025Article
- Colistin heteroresistance, mechanisms, diagnostic methods, and therapeutic options: A review.Germs · 2025Review
- Gallium nitrate inhibits multidrug-resistant Acinetobacter baumannii isolated from bloodstream infection by disrupting multiple iron-dependent metabolic processes.BMC microbiology · 2025Article
- Emergence of population heterogeneity in Klebsiella pneumoniae with a blaJournal of biomedical science · 2025Article
- Insight into the Mechanisms and Clinical Relevance of Antifungal Heteroresistance.Journal of fungi (Basel, Switzerland) · 2025Review
- Epidemiology, mechanisms, and clinical impact of bacterial heteroresistance.npj antimicrobials and resistance · 2025Review
- Detection and characterization of eravacycline heteroresistance in clinical bacterial isolates.Frontiers in microbiology · 2024Article
- Antibiotic heteroresistance and persistence: an additional aid in hospital acquired infections byFuture microbiology · 2024Review
- Medical Device-Associated Healthcare Infections: Sterilization and the Potential of Novel Biological Approaches to Ensure Patient Safety.International journal of molecular sciences · 2023Review
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundWe investigated the presence of heteroresistance against both tigecycline and colistin in Acinetobacter baumannii and then evaluated the effectiveness of combined antibiotic treatment given the existence of discrete tigecycline- and colistin-resistant subpopulations.
methodsWe performed population analysis profiling (PAP) to evaluate the degree of composite heteroresistance in A. baumannii isolates, with the extent of this resistance quantified using subsequent antibiotic susceptibility testing. We then evaluated the amino acid sequence of PmrBAC and the relative mRNA expression levels of pmrB. Finally, we investigated the combined antibiotic efficacy of tigecycline and colistin in multiple-heteroresistant isolates using dual PAP and in vitro time-killing assays.
resultsAll tigecycline-heteroresistant A. baumannii isolates, with the exception of one colistin-resistant isolate, were also heteroresistant to colistin. Evaluations of the colistin-resistant subpopulations revealed amino acid alterations in PmrA and PmrB and increased expression of pmrB. All tigecycline-resistant subpopulations were susceptible to colistin, and all colistin-resistant subpopulations were susceptible to tigecycline. Dual PAP analysis using tigecycline and colistin showed no heteroresistance, and in vitro time-killing assays revealed that a combination of these two antibiotics effectively eliminated the bacterial cells.
conclusionOur results suggest that multiple heteroresistance to tigecycline and colistin is highly prevalent among A. baumannii clinical isolates and that these resistant subpopulations exist independently in single multiple heteroresistant isolates. Therefore, our findings may explain the success of combined antibiotic therapies in these infections.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.