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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/31707


    標題: Comparison of synergism between colistin, fosfomycin and tigecycline against extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolates or with carbapenem resistance
    作者: Ku, Yee-Huang
    Chen, Chi-Chung
    Lee, Mei-Feng
    Chuang, Yin-Ching
    Tang, Hung-Jen
    Yu, Wen-Liang
    貢獻者: Chi Mei Med Ctr, Div Infect Dis, Dept Internal Med
    Chi Mei Med Ctr, Dept Med Res
    Chi Mei Hosp, Div Infect Dis, Dept Internal Med
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    Chi Mei Med Ctr, Dept Intens Care Med
    Taipei Med Univ, Dept Med, Sch Med, Coll Med
    關鍵字: Carbapenem resistance
    Colistin
    ESBL
    Fosfomycin
    Tigecycline
    日期: 2017-12
    上傳時間: 2018-11-30 15:53:41 (UTC+8)
    出版者: Elsevier Taiwan
    摘要: Purpose: To investigate the synergistic and bactericidal effects of antimicrobial combinations of any two of colistin, fosfomycin and tigecycline against the nine extended-spectrum beta-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 x 10(5) CFU/mL by using 1/2 x MIC for each alone, and both 1/2 x and 1/4 x 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 1/2 x MIC and 1/4 xMIC, respectively. The least active combination was tigecycline plus fosfomycin, which showed synergy in only 4 isolates and no bactericidal activities by using concentrations of 1/2 x MIC and 1/4 x 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. Copyright (c) 2017, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC.
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