Strategies for the treatment of polymyxin B-resistant Acinetobacter baumannii infections

Menegucci, Thatiany Cevallos; Albiero, James; Migliorini, Letícia Busato; Alves, Janio Leal Borges; Viana, Giselle Fukita; Mazucheli, Josmar; Carrara-Marroni, Floristher Elaine; Cardoso, Celso Luíz; Tognim, Maria Cristina Bronharo

doi:10.1016/j.ijantimicag.2016.02.007

Cited by 19 publications

(12 citation statements)

References 24 publications

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“…For meropenem–polymyxin B combinations ( Figure 6 ), tests were carried out on 99 strains in four studies, and showed a pooled synergy rate of 37.0% (95% CI, 0.0%–100.0%) and heterogeneity ( I 2 ) was 98.1%. 13 , 26 , 39 , 51 Owing to its high heterogeneity, we used the random-effect model for statistical analysis. No isolates were found to be antagonistic.…”

Section: Resultsmentioning

confidence: 99%

Synergy effect of meropenem-based combinations against <em>Acinetobacter baumannii</em>: a systematic review and meta-analysis

Jiang

2018

IDR

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PurposeThe main objective of our meta-analysis was to examine the in vitro synergistic effect of meropenem-based combination therapies against Acinetobacter baumannii through a systematic review of the existing literature.MethodsAn extensive search was performed with no restrictions on date of publication, language, and publication type. Our study evaluated the main conclusions drawn from various studies describing the synergistic activity of combination therapies in vitro.ResultsIn this review, 56 published studies were included. Our report included data on 20 types of antibiotics combined with meropenem in 1,228 Acinetobacter baumannii isolates. In time-kill studies, meropenem combined with polymyxin B and rifampicin showed synergy rates of 98.3% (95% CI, 83.7%–100.0%) and 89.4% (95% CI, 57.2%–100.0%), respectively, for Acinetobacter baumannii, modest synergy rates were found for meropenem combined with several antibiotics such as colistin and sulbactam, and no synergy effect was displayed in the combination of meropenem and ciprofloxacin, whereas in checkerboard method, the synergy rates of polymyxin B and rifampicin were 37.0% (95% CI, 0.00%–100.0%) and 56.3% (95% CI, 8.7%–97.8%), respectively.ConclusionWe found that time-kill studies generally identified the greatest synergy, while checkerboard and Etest methods yielded relatively poor synergy rates. Further well-designed in vivo studies should be carried out to confirm these findings.

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Section: Resultsmentioning

confidence: 99%

Synergy effect of meropenem-based combinations against <em>Acinetobacter baumannii</em>: a systematic review and meta-analysis

Jiang

2018

IDR

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“…Bacterial suspensions at the mid-log phase of growth (1-5x10 5 Cfu/ml) were added to the plates, and the plates were subsequently incubated at 37˚C for 24 h. The effects of the combinations were analyzed by calculating the fractional inhibitory concentration index (FICI) of each combination as follows: (MIC drug'A' in combination)/(MIC drug'A' alone)+(MIC drug'B' in combination)/(MIC drug'B' alone). The effect was considered synergistic if the FICI was ≤0.5, additive if the FICI was >0.5 and ≤4.0, and antagonistic if the FICI was >4.0 (15).…”

Section: Methodsmentioning

confidence: 99%

Effects of the antimicrobial peptide L12 against multidrug‑resistant Staphylococcus aureus

Dai

et al. 2019

Mol Med Report

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Methicillin-resistant Staphylococcus aureus (S. aureus; MRSA) is one of the most common bacterial pathogens and MRSA infections are characterized by high mortality rates. Antimicrobial peptides are considered one of the most promising drugs for the treatment of resistant strains of S. aureus. The present study aimed to examine the antimicrobial activity of L12 against numerous bacterial species using the broth microdilution method. Furthermore, the synergistic effect of L12 combined with various antibacterial drugs was tested, and its antibacterial mechanism was investigated by a checkerboard assay. The alterations in bacterial morphology were detected by electron microscopy, and biofilm formation and removal were tested by crystal violet staining. The present results suggested that L12 affected the growth of gram-positive strains, particularly S. aureus. Electron microscopy analysis suggested that L12 may target the cell membrane, and L12 increased the antibacterial activity of vancomycin and levofloxacin, exerting a synergistic effect. However, the minimal inhibitory concentrations (MICs) of L12 were not correlated with antibiotic resistance, the strains resistant to more antibiotics were not more resistant to L12. A sub-MIC of L12 was able to inhibit biofilm formation in a dose-dependent manner; however, concentrations of L12 ≤10 times the MIC were not sufficient to degrade previously formed biofilm. Collectively, the present study suggested that L12 may represent a novel potential therapeutic molecule for the treatment of S. aureus infections.

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“…Several studies 39 have reported that polymixin B is the most effective antibiotic for Acinetobacter strains. Zorgani et al, Attia and ElBaradei, Josheghani et al, currently, the use of polymyxin B combined with other antibiotic agents, such as carbapenems, rifampicin, and sulbactam, is recommended antibiotic therapy treatment for pneumonia and bacteraemia infections caused by MDR A. baumannii [40][41][42] .…”

Section: Polymyxins (Cell Membrane Inhibitors)mentioning

confidence: 99%

Antibiotic Resistance of Acinetobacter Baumannii: An Urgent Need for New Therapy and Infection Control

Abd-ElNasser

Abdelrahim

Mahmoud

et al. 2020

Bulletin of Pharmaceutical Sciences. Assiut

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Strategies for the treatment of polymyxin B-resistant Acinetobacter baumannii infections

Cited by 19 publications

References 24 publications

Synergy effect of meropenem-based combinations against <em>Acinetobacter baumannii</em>: a systematic review and meta-analysis

Synergy effect of meropenem-based combinations against <em>Acinetobacter baumannii</em>: a systematic review and meta-analysis

Effects of the antimicrobial peptide L12 against multidrug‑resistant Staphylococcus aureus

Antibiotic Resistance of Acinetobacter Baumannii: An Urgent Need for New Therapy and Infection Control

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