Efficacy of generic meropenem products in combination with colistin in carbapenemase-producing Klebsiella pneumoniae experimental osteomyelitis

Tattevin, Pierre; Dinh, Aurélien; Ghout, Idir; Mouton, William; Verdier, Marie‐Clémence; Laurent, Frédéric; Lemaître, F.; Gatin, L.; Saleh‐Mghir, Azzam; Crémieux, Anne‐Claude

doi:10.1016/j.ijantimicag.2020.106152

Cited by 2 publications

(2 citation statements)

References 26 publications

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“…19 The results of study are supporting the Japanese published data showing 60% clinical efficacy of colistin therapy against multidrug-resistant KP infection. 20 Another study revealed 70% imipenem resistance among KP isolates which is almost similar to our observation of 74% resistance to imipenem. 21 In the present era of increasing AMR perhaps colistin being the only choice left for treatment of such MDR and XDR pathogens.…”

Section: Miscellaneoussupporting

confidence: 89%

In Vitro Susceptibility of Colistin Against Multidrug Resistant Klebsiella Pneumoniae Clinical Isolates

Fayyaz

Zafar²,

Mirza

et al. 2022

PAFMJ

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Objectives: To determine in-vitro efficacy of colistin against resistant Klebsiella Pneumoniae clinical isolates. Study Design: Cross-sectional study. Place and Duration of Study: Microbiology Department of Pathology Lab, Armed Forces Institute of Cardiology & National Institute of Heart Diseases, Rawalpindi, Pakistan, from Jan 2021 to Dec 2021. Methodology: This cross-sectional study was carried out at the microbiology department of pathology lab, Armed Forces institute of Cardiology & National Institute of Heart Diseases, Rawalpindi through Jan 2021 to Dec 2021. Sampling was done by nonprobability consecutive technique. Antimicrobial susceptibility testing was done for all clinical isolates of KP. Results: A total of 3066 culture and sensitivity requests were received, out of these 663(21.6%) specimens revealed growth of different microorganisms. Amongst 663 culture positive isolates, 150(22.6 %) were identified as KP. Antibiotic susceptibility of KP showed >90% isolates resistant to 3rd & 4th generation cephalosporins, cotrimoxazole, ampicillin+salbactum and coamoxiclav. Aminoglycosides, quinolones, meropenem, aztreonam and tazobactum+pipracillin were found resistant in >80% isolates and doxycycline and imipenem in >70% isolates. Resistance to minocycline was 58%, chloramphenicol 40.7% and Tigecycline 38.7%. The least resistance was noted in Colistin 16%. Conclusion: A very high antimicrobial resistance was observed in KP isolates against penicillins, cephalosporins, ampicillin beta lactamase inhibitor combinations, quinolones, aminoglycosides, carbapenems and cotrimoxazole. Comparatively tigecyclines and chloramphenicol were found to be less resistant than other antimicrobials to manage MDR and XDR cases. Colistin has excellent efficacy against MDR and XDR KP isolates.

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Section: Miscellaneoussupporting

confidence: 89%

In Vitro Susceptibility of Colistin Against Multidrug Resistant Klebsiella Pneumoniae Clinical Isolates

Fayyaz

Zafar²,

Mirza

et al. 2022

PAFMJ

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“…Hagihara et al, found that meropenem plus amikacin was effective against KPC-, IMP-and OXA-48-producing K. pneumoniae infections, except for NDM type carbapenemase producing (13). Also, the combination of meropenem plus colistin was found to be bactericidal against a KPC-producing K. pneumoniae experimental osteomyelitis in rabbits (14). Several studies have suggested fosfomycin combination with other antimicrobials to be explored because of its in vitro activity.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Fosfomycin and Its Combination With Aminoglycosides in an Experimental Sepsis Model by Carbapenemase-Producing Klebsiella pneumoniae Clinical Strains

et al. 2021

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Carbapenemase-producing Klebsiella pneumoniae infections are an increasing global threat with scarce and uncertain treatment options. In this context, combination therapies are often used for these infections. The bactericidal and synergistic activity of fosfomycin plus amikacin and gentamicin was studied trough time–kill assays against four clonally unrelated clinical isolates of carbapenemase-producing K. pneumoniae, VIM-1, VIM-1 plus DHA-1, OXA-48 plus CTXM-15, and KPC-3, respectively. The efficacy of antimicrobials that showed synergistic activity in vitro against all the carbapenemase-producing K. pneumoniae were tested in monotherapy and in combination, in a murine peritoneal sepsis model. In vitro, fosfomycin plus amikacin showed synergistic and bactericidal effect against strains producing VIM-1, VIM-1 plus DHA-1, and OXA-48 plus CTX-M-15. Fosfomycin plus gentamicin had in vitro synergistic activity against the strain producing KPC-3. In vivo, fosfomycin and amikacin and its combination reduced the spleen bacterial concentration compared with controls groups in animals infected by K. pneumoniae producing VIM-1 and OXA-48 plus CTX-M-15. Moreover, amikacin alone and its combination with fosfomycin reduced the bacteremia rate against the VIM-1 producer strain. Contrary to the in vitro results, no in vivo efficacy was found with fosfomycin plus amikacin against the VIM-1 plus DHA-1 producer strain. Finally, fosfomycin plus gentamicin reduced the bacterial concentration in spleen against the KPC-3 producer strain. In conclusion, our results suggest that fosfomycin plus aminoglycosides has a dissimilar efficacy in the treatment of this severe experimental infection, when caused by different carbapenemase-producing K. pneumoniae strains. Fosfomycin plus amikacin or plus gentamycin may be useful to treat infections by OXA-48 plus CTX-M-15 or KPC-3 producer strains, respectively.

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Efficacy of generic meropenem products in combination with colistin in carbapenemase-producing Klebsiella pneumoniae experimental osteomyelitis

Cited by 2 publications

References 26 publications

In Vitro Susceptibility of Colistin Against Multidrug Resistant Klebsiella Pneumoniae Clinical Isolates

In Vitro Susceptibility of Colistin Against Multidrug Resistant Klebsiella Pneumoniae Clinical Isolates

Efficacy of Fosfomycin and Its Combination With Aminoglycosides in an Experimental Sepsis Model by Carbapenemase-Producing Klebsiella pneumoniae Clinical Strains

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