| Antibacterial activity of carbapenem-based combinations againts multidrug-resistant Acinetobacter baumannii. | |
| | |
MedLine Citation:
|
PMID: 20301995 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
|
BACKGROUND: Multidrug-resistant (MDR) Acinetobacter baumannii are increasingly encountered and frequently susceptible only to colistin with their MIC values close to resistance breakpoint. Antibacterial activity of two carbapenem-based combinations were explored in order to overcome the bacterial resistance. MATERIAL AND METHOD: Thirty clinical isolates of MDRA. baumannii were employed to assess in vitro antibacterial activity of two carbapenem-based regimens. Imipenem combined with colistin and meropenem combined with colistin and sulbactam were the first and second regimens, respectively. All isolates were resistant to imipenem (MIC range: 8-128 microg/ml) and meropenem (MIC range: 64-256 microg/ml) but still susceptible to colistin (MIC range: 0.5-2 microg/ml). The MIC range of sulbactam was 4-64 microg/ml. None of the isolates produced metallo-beta-lactamase. RESULTS: Synergistic antibacterial effect of imipenem combined with colistin was observed against 100 percent of A. baumannii isolates by the checkerboard microdilution panel method. In a subsequent time kill study, the most active concentration of this regimen was the combination of imipenem at the fixed concentration of 32 microg/ml and colistin at the 1/4 of the MIC values of each isolate that exerted significantly higher bactericidal activity than imipenem at 32 microg/ml alone and colistin alone at the 1/4 of the MIC values. The scanning electron micrographs demonstrated major cell morphological change and cell wall destruction after 2-hour exposure to this combination. The triple combinations of meropenem, sulbactam and colistin showed synergy against 96.7 percent of MDR A. baumannii while double combinations of either meropenem and sulbactam, meropenem and colistin, and sulbactam and colistin showed synergy effects of 70%, 73.3% and 53.3%, respectively The time kill study using ten isolates also showed better killing effect by the triple combination than any of the double combinations. CONCLUSION: Antibacterial activity against MDR A. baumannii of imipenem plus colistin was superior over any single of the two agents. The addition of sulbactam to meropenem and colistin may further improve their antibacterial activity. The double or triple carbapenem-based combinations offer promising alternatives in the treatment of infections due to MDR A. baumannii. |
| | |
Authors:
|
Pintip Pongpech; Suparak Amornnopparattanakul; Sakulthip Panapakdee; Siriporn Fungwithaya; Penphun Nannha; Chertsak Dhiraputra; Amorn Leelarasamee |
Related Documents
:
|
15886475 - Bacteremia in patients with hematological malignancies. 19738025 - Molecular epidemiology and mechanisms of carbapenem resistance in pseudomonas aeruginosa. 19802985 - Ceftazidime, a pseudomonas-active cephalosporin: in-vitro antimicrobial activity evalua... 19221815 - Evaluation of meropenem alone and combined with rifampin in the guinea pig model of pne... 18355295 - Occurrence, seasonality and genetic diversity of vibrio vulnificus in coastal seaweeds ... 19878595 - Experimental infection in calves with a specific subtype of verocytotoxin-producing esc... |
Publication Detail:
|
Type: In Vitro; Journal Article |
Journal Detail:
|
Title: Journal of the Medical Association of Thailand = Chotmaihet thangphaet Volume: 93 ISSN: 0125-2208 ISO Abbreviation: J Med Assoc Thai Publication Date: 2010 Feb |
Date Detail:
|
Created Date: 2010-03-22 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7507216 Medline TA: J Med Assoc Thai Country: Thailand |
Other Details:
|
Languages: eng Pagination: 161-71 Citation Subset: IM |
Affiliation:
|
Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Reference centile chart for fetal nuchal translucency, maternal serum PAPP-A and free beta hCG.
Next Document: Comparison of continuous infusion versus intermittent infusion of vancomycin in patients with methic...