In vitro activity of biapenem and comparators against multidrug-resistant and carbapenem-resistant Acinetobacter baumannii isolated from tertiary care hospitals in Thailand

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Acinetobacter baumannii is one of nosocomial pathogen which emerges as multidrug-resistance worldwide.Multidrugresistant A. baumannii (MDRAB) and carbapenem-resistant A. baumannii (CRAB) are highly concerned due to limitation of therapeutic options.Antibacterial activity of biapenem was explored in order to overcome bacterial resistance.A total of 412 A. baumannii clinical isolates from 13 tertiary care hospitals in Thailand were collected.MIC values of biapenem and comparators; imipenem, meropenem, colistin, sulbactam, ciprofloxacin ceftazidime and fosfomycin sodium, were determined by broth microdilution method in accordance with the Clinical and Laboratory Standards Institute (CLSI) guidelines (2016).In total, 320 isolates (77.67%) were MDRAB and 328 isolates (79.61%) were CRAB while 58 isolates (14.07%) were colistin-resistant AB. A. baumannii showed widespread resistance to ceftazidime, ciprofloxacin and carbapenems in more than 90% of the strains; resistance to sulbactam, fosfomycin, and colistin were 85%, 60%, and 15% respectively.By comparison among carbapenems, biapenem showed MIC 50/90 of 16/32 which were at least 2 folds lower than imipenem and meropenem (MIC 50/90 ; 32/128, 32/64, respectively).In addition, 15% of imipenem and meropenemresistant A. baumannii were susceptible to biapenem.Also, 19% of colistin-resistant A. baumannii were susceptible to biapenem.Although more than 90% of MDRAB and CRAB were resistant to carbapenems, biapenem showed a good activity over other carbapenems.This drug might be a therapeutic option mono or combination therapy besides other antimicrobial agents.