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Assessment of Renal Damage in Patients with Multi-Drug Resistant Strains of Pneumonia Treated with Colistin

Omid Moradi Moghadam 1 , * , Reza Ghanbarpour 2 , Mohammad Niakan 2 , ** , Mahshid Talebi Taher 3 , Valiollah Hassani 2 , Alireza Dadashi 4 and Ebad Shiri 4
Authors Information
1 MD, FCCM Assistant Professor of Anesthesiology and Critical Care department of Iran University Medical Sciences, Rasool-e-Akram complex hospital, Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
2 Iran University of Medical Sciences, Tehran, Iran
3 Antimicrobial Resistant Research Center, Iran University of Medical Sciences, Tehran, Iran
4 AJA University of Medical Sciences, Tehran, Iran
Corresponding Authors:
Article information
  • Trauma Monthly: January 2018, 23 (1); e60002
  • Published Online: January 20, 2018
  • Article Type: Research Article
  • Received: August 17, 2017
  • Revised: September 4, 2017
  • Accepted: October 7, 2017
  • DOI: 10.5812/traumamon.60002

To Cite: Moradi Moghadam O, Ghanbarpour R, Niakan M, Talebi Taher M, Hassani V, et al. Assessment of Renal Damage in Patients with Multi-Drug Resistant Strains of Pneumonia Treated with Colistin, Trauma Mon. 2018 ; 23(1):e60002. doi: 10.5812/traumamon.60002.

Copyright © 2018, Trauma Monthly. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Lahra MM, W. H. O. Western Pacific , South East Asian Gonococcal Antimicrobial Surveillance P. Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO Western Pacific and South East Asian Regions, 2010. Commun Dis Intell Q Rep. 2012;36(1):95-100. [PubMed: 23153085].
  • 2. Ray K, Bala M, Kumari S, Narain JP. Antimicrobial resistance of Neisseria gonorrhoeae in selected World Health Organization Southeast Asia Region countries: an overview. Sex Transm Dis. 2005;32(3):178-84. [PubMed: 15729156].
  • 3. Bala M, Kakran M, Singh V, Sood S, Ramesh V.Members of. Monitoring antimicrobial resistance in Neisseria gonorrhoeae in selected countries of the WHO South East Asia Region between 2009 and 2012, a retrospective analysis. Sex Transm Infect. 2013;89 Suppl 4:28-35. doi: 10.1136/sextrans-2012-050904. [PubMed: 24243876].
  • 4. Tapsall JW. Antibiotic resistance in Neisseria gonorrhoeae. Clin Infect Dis. 2005;41 Suppl 4:263-8. doi: 10.1086/430787. [PubMed: 16032562].
  • 5. Unemo M, Ison CA, Cole M, Spiteri G, van de Laar M, Khotenashvili L. Gonorrhoea and gonococcal antimicrobial resistance surveillance networks in the WHO European region, including the independent countries of the former Soviet Union. Sex Transm Infect. 2013;89 Suppl 4:42-6. doi: 10.1136/sextrans-2012-050909. [PubMed: 24243879].
  • 6. Xu W, He L, Liu C, Rong J, Shi Y, Song W, et al. The effect of infection control nurses on the occurrence of pseudomonas aeruginosa healthcare acquired infection and multidrug resistant strains in critically Ill children. PLoS One. 2015;10(12):143692. doi: 10.1371/journal.pone.0143692. [PubMed: 26630032].
  • 7. Blanquer D, De Otero J, Padilla E, Gomez F, Mayol A, Irigaray R, et al. Tigecycline for treatment of nosocomial-acquired pneumonia possibly caused by multi-drug resistant strains of Stenotrophomonas maltophilia. J Chemother. 2008;20(6):761-3. doi: 10.1179/joc.2008.20.6.761. [PubMed: 19129079].
  • 8. Miravitlles M, Anzueto A. Moxifloxacin: a respiratory fluoroquinolone. Expert Opin Pharmacother. 2008;9(10):1755-72. doi: 10.1517/14656566.9.10.1755. [PubMed: 18570608].
  • 9. Mastoraki A, Douka E, Kriaras I, Stravopodis G, Manoli H, Geroulanos S. Pseudomonas aeruginosa susceptible only to colistin in intensive care unit patients. Surg Infect (Larchmt). 2008;9(2):153-60. doi: 10.1089/sur.2007.004. [PubMed: 18426347].
  • 10. Miravitlles M. Moxifloxacin in respiratory tract infections. Expert Opin Pharmacother. 2005;6(2):283-93. doi: 10.1517/14656566.6.2.283. [PubMed: 15757424].
  • 11. Anderson G, Deceuninck G, Zhou Z, Boucher FD, Bonnier Viger Y, Gilca R, et al. Hospitalisation for lower respiratory tract infection in children in the province of quebec, Canada, before and during the pneumococcal conjugate vaccine era. Epidemiol Infect. 2017;145(13):2770-6. doi: 10.1017/S0950268817001510. [PubMed: 28803551].
  • 12. Antonello VS, Daht P, Polli J, Gross MJ, Colvero M. Ventilator associated pneumonia in neonatal intensive care unit due to chryseobacterium indologenes. Pediatr Infect Dis J. 2017;36(12):353-5. doi: 10.1097/INF.0000000000001730. [PubMed: 28806281].
  • 13. Di Pasquale M, Aliberti S, Azzari C, Moriondo M, Nieddu F, Blasi F, et al. Serotypes and antibiotic susceptibility of Streptococcus pneumoniae isolated from hospitalized patients with community acquired pneumonia in Italy. SAGE Open Med. 2017;5:2.0503121177201E+15. doi: 10.1177/2050312117720058. [PubMed: 28781877].
  • 14. Shindo Y, Hasegawa Y. Regional differences in antibiotic resistant pathogens in patients with pneumonia, implications for clinicians. Respirology. 2017;22(8):1536-46. doi: 10.1111/resp.13135. [PubMed: 28779516].
  • 15. Khan ID, Basu A, Kiran S, Trivedi S, Pandit P, Chattoraj A. Device associated healthcare associated infections, (DA HAI) and the caveat of multiresistance in a multidisciplinary intensive care unit. Med J Armed Forces India. 2017;73(3):222-31. doi: 10.1016/j.mjafi.2016.10.008. [PubMed: 28790779].
  • 16. Gilbert DN. Role of procalcitonin in the management of infected patients in the intensive care unit. Infect Dis Clin North Am. 2017;31(3):435-53. doi: 10.1016/j.idc.2017.05.003. [PubMed: 28779830].
  • 17. Garnacho-Montero J, Gutierrez-Pizarraya A, Lopez-Garcia I, Miranda JC, Gonzalez-Galan V, Corcia-Palomo Y, et al. Pneumonia in mechanically ventilated patients: no diagnostic and prognostic value of different quantitative tracheal aspirates thresholds. Infect Dis (Lond). 2018;50(1):44-51. doi: 10.1080/23744235.2017.1362110. [PubMed: 28776434].
  • 18. Sachdeva D, Singh D, Loomba P, Kaur A, Tandon M, Bishnoi I. Assessment of surgical risk factors in the development of ventilator associated pneumonia in neurosurgical intensive care unit patients, Alarming observations. Neurol India. 2017;65(4):779-84. doi: 10.4103/neuroindia.NI_814_16. [PubMed: 28681751].
  • 19. Bahy RH, Hamouda HM, Shahat AS, Yassin AS, Amin MA. Development and evaluation of a novel vaccine against prevalent invasive multi drug resistant strains of Streptococcus pneumoniae. PeerJ. 2016;4:2737. doi: 10.7717/peerj.2737. [PubMed: 27917323].
  • 20. Angaali N, Roy ND, Chitgupikar SR, Subramanian P, Pabbati JL. Ventilator associated pneumonia in an infant caused by stenotrophomonas maltophila, a case report. J Clin Diagn Res. 2016;10(9):1-3. doi: 10.7860/JCDR/2016/19822.8411. [PubMed: 27790437].
  • 21. Protic D, Pejovic A, Andjelkovic D, Djukanovic N, Savic D, Piperac P, et al. Nosocomial Infections Caused by Acinetobacter baumannii: Are We Losing the Battle?. Surg Infect (Larchmt). 2016;17(2):236-42. doi: 10.1089/sur.2015.128. [PubMed: 26885722].
  • 22. Foletti D, Strop P, Shaughnessy L, Hasa-Moreno A, Casas MG, Russell M, et al. Mechanism of action and in vivo efficacy of a human-derived antibody against Staphylococcus aureus alpha-hemolysin. J Mol Biol. 2013;425(10):1641-54. doi: 10.1016/j.jmb.2013.02.008. [PubMed: 23416200].
  • 23. Jones RN, Castanheira M, Hu B, Ni Y, Lin SS, Mendes RE, et al. Update of contemporary antimicrobial resistance rates across China: reference testing results for 12 medical centers (2011). Diagn Microbiol Infect Dis. 2013;77(3):258-66. doi: 10.1016/j.diagmicrobio.2013.07.003. [PubMed: 24055218].
  • 24. Antoniu SA, Cojocaru I. Inhaled colistin for lower respiratory tract infections. Expert Opin Drug Deliv. 2012;9(3):333-42. doi: 10.1517/17425247.2012.660480. [PubMed: 22332963].
  • 25. Rodriguez-Roldan JM, Altuna-Cuesta A, Lopez A, Carrillo A, Garcia J, Leon J, et al. Prevention of nosocomial lung infection in ventilated patients: use of an antimicrobial pharyngeal nonabsorbable paste. Crit Care Med. 1990;18(11):1239-42. [PubMed: 2225893].
  • 26. Hernandez M, Iglesias MR, Rodriguez-Lazaro D, Gallardo A, Quijada N, Miguela-Villoldo P, et al. Co occurrence of colistin resistance genes mcr 1 and mcr 3 among multidrug-resistant Escherichia coli isolated from cattle, Spain, September 2015. Euro Surveill. 2017;22(31). doi: 10.2807/1560-7917.ES.2017.22.31.30586. [PubMed: 28797328].
  • 27. Kluytmans J. Plasmid encoded colistin resistance, mcr one, two, three and counting. Euro Surveill. 2017;22(31). doi: 10.2807/1560-7917.ES.2017.22.31.30588. [PubMed: 28797321].
  • 28. Tada T, Uechi K, Nakasone I, Shimada K, Nakamatsu M, Kirikae T, et al. Emergence of a colistin resistant Escherichia coli clinical isolate harboring mcr 1 in Japan. Int J Infect Dis. 2017;63:21-2. doi: 10.1016/j.ijid.2017.07.023. [PubMed: 28780184].
  • 29. Haque A, Ishii Y, Akasaka Y, Matsumoto T, Tateda K. Administration of colistin sulfate in endotoxic model at slow and sustained fashion may reverse shock without causing nephrotoxicity in its optimal concentration. J Glob Antimicrob Resist. 2017;11:40-4. doi: 10.1016/j.jgar.2017.07.014. [PubMed: 28774864].
  • 30. Mansour W, Haenni M, Saras E, Grami R, Mani Y, Ben Haj Khalifa A, et al. Outbreak of colistin-resistant carbapenemase-producing Klebsiella pneumoniae in Tunisia. J Glob Antimicrob Resist. 2017;10:88-94. doi: 10.1016/j.jgar.2017.03.017. [PubMed: 28711559].
  • 31. Ghafur A, Gohel S, Devarajan V, Raja T, Easow J, Raja MA, et al. Colistin nephrotoxicity in adults, single centre large series from India. Indian J Crit Care Med. 2017;21(6):350-4. doi: 10.4103/ijccm.IJCCM_140_17. [PubMed: 28701840].
  • 32. Katip W. Visual compatibility of colistin injection with other antibiotics during simulated Y site administration. Am J Health Syst Pharm. 2017;74(14):1099-102. doi: 10.2146/ajhp160216. [PubMed: 28687555].
  • 33. Antachopoulos C, Iosifidis E. Colistin use in neonates and children with infections due to carbapenem resistant bacteria. Pediatr Infect Dis J. 2017;36(9):905-7. doi: 10.1097/INF.0000000000001655. [PubMed: 28650936].
  • 34. Pourhajibagher M, Kazemian H, Chiniforush N, Bahador A. Evaluation of photodynamic therapy effect along with colistin on pandrug-resistant Acinetobacter baumannii. Laser Ther. 2017;26(2):97-103. doi: 10.5978/islsm.17-OR-7. [PubMed: 28785129].
  • 35. Boluki E, Kazemian H, Peeridogaheh H, Alikhani MY, Shahabi S, Beytollahi L, et al. Antimicrobial activity of photodynamic therapy in combination with colistin against a pan-drug resistant Acinetobacter baumannii isolated from burn patient. Photodiagnosis Photodyn Ther. 2017;18:1-5. doi: 10.1016/j.pdpdt.2017.01.003. [PubMed: 28088439].
  • 36. Takizawa E, Yamada K, Oinuma K, Sato K, Niki M, Namikawa H, et al. An Intrinsic Strain of Colistin-resistant Acinetobacter Isolated from a Japanese Patient. Intern Med. 2016;55(16):2301-6. doi: 10.2169/internalmedicine.55.6807. [PubMed: 27523013].
  • 37. Hachem RY, Chemaly RF, Ahmar CA, Jiang Y, Boktour MR, Rjaili GA, et al. Colistin is effective in treatment of infections caused by multidrug-resistant Pseudomonas aeruginosa in cancer patients. Antimicrob Agents Chemother. 2007;51(6):1905-11. doi: 10.1128/AAC.01015-06. [PubMed: 17387153].
  • 38. Falagas ME, Kasiakou SK. Toxicity of polymyxins, a systematic review of the evidence from old and recent studies. Crit Care. 2006;10(1):27. doi: 10.1186/cc3995. [PubMed: 16507149].
  • 39. Spapen H, Jacobs R, Van Gorp V, Troubleyn J, Honore PM. Renal and neurological side effects of colistin in critically ill patients. Ann Intensive Care. 2011;1(1):14. doi: 10.1186/2110-5820-1-14. [PubMed: 21906345].
  • 40. Chen Z, Chen Y, Fang Y, Wang X, Chen Y, Qi Q, et al. Meta-analysis of colistin for the treatment of Acinetobacter baumannii infection. Sci Rep. 2015;5:17091. doi: 10.1038/srep17091. [PubMed: 26597507].
  • 41. Koksal I, Kaya S, Gencalioglu E, Yilmaz G. Evaluation of Risk Factors for Intravenous Colistin Use-related Nephrotoxicity. Oman Med J. 2016;31(4):318-21. doi: 10.5001/omj.2016.62. [PubMed: 27403248].
  • 42. Binh NG, Hayakawa K, Co DX, Tuan ND, Anh NH, Thuy NT, et al. The efficacy and nephrotoxicity associated with colistin use in an intensive care unit in Vietnam: Use of colistin in a population of lower body weight. Int J Infect Dis. 2015;35:18-23. doi: 10.1016/j.ijid.2015.03.020. [PubMed: 25835100].
  • 43. Elefritz JL, Bauer KA, Jones C, Mangino JE, Porter K, Murphy CV. Efficacy and safety of a colistin loading dose, high dose maintenance regimen in critically ill patients with multidrug resistant gram negative pneumonia. J Intensive Care Med. 2017;32(8):487-93. doi: 10.1177/0885066616646551. [PubMed: 27139010].
  • 44. Valachis A, Samonis G, Kofteridis DP. The role of aerosolized colistin in the treatment of ventilator-associated pneumonia: a systematic review and metaanalysis. Crit Care Med. 2015;43(3):527-33. doi: 10.1097/CCM.0000000000000771. [PubMed: 25493971].
  • 45. Nachiappan M, Litake MM. Scoring systems for outcome prediction of patients with perforation peritonitis. J Clin Diagn Res. 2016;10(3):1-5. doi: 10.7860/JCDR/2016/16260.7338. [PubMed: 27134924].
  • 46. Lammers WJ, Hirschfield GM, Corpechot C, Nevens F, Lindor KD, Janssen HL, et al. Development and validation of a scoring system to predict outcomes of patients with primary biliary cirrhosis receiving ursodeoxycholic acid therapy. Gastroenterology. 2015;149(7):1804-12. doi: 10.1053/j.gastro.2015.07.061. [PubMed: 26261009].
  • 47. Rapsang AG, Shyam DC. Scoring systems in the intensive care unit: A compendium. Indian J Crit Care Med. 2014;18(4):220-8. doi: 10.4103/0972-5229.130573. [PubMed: 24872651].
  • 48. Vincent JL, Moreno R. Clinical review: scoring systems in the critically ill. Crit Care. 2010;14(2):207. doi: 10.1186/cc8204. [PubMed: 20392287].
  • 49. Asadzandi M, Karati T, Tadrisi SD, Ebadi A. Estimation of the mortality rate using the APACHE II standard disease severity scoring system in intensive care unit patients. J Crit Care Nurs. 2012;4(4):209-14.
  • 50. Rahimzadeh P, Taghipouranvari Z, Hasani V. The estimation of mortality rate based on APACHE II scoring system in surgical critical care unit at Hazrat Rasoul Akram Hospital. Hakim Med J. 2008;11(1):22-8.
  • 51. De Campos T, Cerqueira C, Kuryura L, Parreira JG, Solda S, Perlingeiro JA, et al. Morbimortality indicators in severe acute pancreatitis. JOP. 2008;9(6):690-7. [PubMed: 18981549].
  • 52. Costa e Silva VT, de Castro I, Liano F, Muriel A, Rodriguez-Palomares JR, Yu L. Performance of the third-generation models of severity scoring systems (APACHE IV, SAPS 3 and MPM-III) in acute kidney injury critically ill patients. Nephrol Dial Transplant. 2011;26(12):3894-901. doi: 10.1093/ndt/gfr201. [PubMed: 21505093].
  • 53. Hussaini M, Ramzani J. Assessment, (SOFA) scoring systems for prognostication of outcomes among intensive care unit patients in Bojnourd Emam Ali and Emam Reza Hospitals. Iran J Anesth Crit Care. 2016;37(89):37-44.
  • 54. Gul S, Kuscu F, Aydemir H, Ozturk DB, Deveci O, Duygu F, et al. Risk Factors for Colistin-Associated Acute Kidney Injury: A Multicenter Study from Turkey. Jpn J Infect Dis. 2016;69(2):109-12. doi: 10.7883/yoken.JJID.2014.501. [PubMed: 26166495].
  • 55. Rocco M, Montini L, Alessandri E, Venditti M, Laderchi A, De Pascale G, et al. Risk factors for acute kidney injury in critically ill patients receiving high intravenous doses of colistin methanesulfonate and or other nephrotoxic antibiotics, a retrospective cohort study. Crit Care. 2013;17(4):174. doi: 10.1186/cc12853. [PubMed: 23945197].

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