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Comparison of synergism between colistin, fosfomycin and tigecycline against extended-spectrum β-lactamase-producing Klebsiella pneumoniae isolates or with carbapenem resistance
- Source :
- Journal of Microbiology, Immunology and Infection, Vol 50, Iss 6, Pp 931-939 (2017)
- Publication Year :
- 2016
-
Abstract
- Purpose: To investigate the synergistic and bactericidal effects of antimicrobial combinations of any two of colistin, fosfomycin and tigecycline against the nine extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae (KP) clinical isolates, including 4 carbapenem-susceptible strains and five imipenem and/or meropenem-resistant strains. Methods: In vitro synergism and bactericidal activity of combination of colistin, fosfomycin and tigecycline were evaluated by time-kill studies in standard inoculum of bacterial densities of a suspension containing 5 Ã 105 CFU/mL by using 1/2à MIC for each alone, and both 1/2à and 1/4à MIC for any two drugs. The settings of low MIC dosing were allowed to rapidly survey the most active drug combination. Results: The most active combination group was colistin plus tigecycline, showing synergy in 8 isolates and bactericidal activities in 6 isolates by using concentrations of 1/2à MIC and 1/4à MIC, respectively. The least active combination was tigecycline plus fosfomycin, which showed synergy in only 4 isolates and no bactericidal activities by using concentrations of 1/2à MIC and 1/4à MIC, respectively. Conclusions: The combination of tigecycline and colistin may be considered as a last-resort approach to the ESBL-producing KP infections, especially those isolates with carbapenem resistance. Keywords: Carbapenem resistance, Colistin, ESBL, Fosfomycin, Tigecycline
- Subjects :
- 0301 basic medicine
Microbiology (medical)
Imipenem
Klebsiella pneumoniae
030106 microbiology
lcsh:QR1-502
Minocycline
Tigecycline
Carbapenem-resistant enterobacteriaceae
Microbial Sensitivity Tests
Biology
Fosfomycin
lcsh:Microbiology
beta-Lactamases
Microbiology
03 medical and health sciences
Drug Resistance, Multiple, Bacterial
polycyclic compounds
medicine
Immunology and Allergy
Humans
General Immunology and Microbiology
Colistin
Drug Synergism
General Medicine
biochemical phenomena, metabolism, and nutrition
bacterial infections and mycoses
Antimicrobial
biology.organism_classification
Anti-Bacterial Agents
Klebsiella Infections
Drug Combinations
Infectious Diseases
Carbapenem-Resistant Enterobacteriaceae
bacteria
medicine.drug
Subjects
Details
- ISSN :
- 19959133
- Volume :
- 50
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi
- Accession number :
- edsair.doi.dedup.....231bc5a5f12da92df17fb7324c3921ef