Comparison of synergism between colistin, fosfomycin and tigecycline against extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolates or with carbapenem resistance

doi:10.1016/j.jmii.2016.12.008

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Title:	Comparison of synergism between colistin, fosfomycin and tigecycline against extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolates or with carbapenem resistance
Authors:	Ku, Yee-Huang Chen, Chi-Chung Lee, Mei-Feng Chuang, Yin-Ching Tang, Hung-Jen Yu, Wen-Liang
Contributors:	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
Keywords:	Carbapenem resistance Colistin ESBL Fosfomycin Tigecycline
Date:	2017-12
Issue Date:	2018-11-30 15:53:41 (UTC+8)
Publisher:	Elsevier Taiwan
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 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.
Relation:	Journal of Microbiology Immunology and Infection, v.50, n.6, pp.931-939
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Dissertations and Theses

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