Synergistic antibiotic combinations for colistin-resistant<i>Klebsiella pneumoniae</i>

Kádár, Béla; Kocsis, Béla; Tóth, Ákos; Damjanova, Ivelina; Szász, M.; Kristóf, Katalin; Nagy, K.; Szabó, Dóra

doi:10.1556/amicr.60.2013.2.10

Cited by 12 publications

(3 citation statements)

References 25 publications

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“…The treatment of these polymyxin-resistant enterobacteria is a great challenge, although some recent studies showed that antibiotic combinations involving e.g. polymyxins, rifampicin, carbapenems and aminoglycosides could be effi cient [29].…”

Section: Discussionmentioning

confidence: 99%

Effect of antimicrobial peptides on colistin-susceptible and colistin-resistant strains of Klebsiella pneumoniae and Enterobacter asburiae

Kádár

Kocsis

Kristóf³

et al. 2015

Acta Microbiologica et Immunologica Hungarica

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In this study susceptibility to different antimicrobial peptides was investigated on colistin-susceptible and colistin-resistant identical pulsotype strains of KPC-2 producing Klebsiella pneumoniae ST258 as well as colistin-susceptible and colistin-resistant Enterobacter asburiae strains isolated from clinical samples. In our test, bacteria were exposed to 50 mg/ml lactoferrin, lysozyme and protamine - cationic antimicrobial peptides belonging to innate immune system and having structural similarity to polymyxins - in separate reactions. After 18 hours incubation of colonies were counted. 40% of colistin-resistant K. pneumoniae strains and 97% of colistin-susceptible counterpart strains were lysed by protamine whereas 87% and 100% colony forming unit decrease by lysozyme was seen, respectively. In the case of colistin-resistant E. asburiae strains 1 log10 cell count increase were observed after treatment with lysozyme and 1.56 log10 after lactoferrin exposure compared to the initial number whereas the colistin-susceptible showed no relevant cell count increase. Our findings suggest that acquired colistin-resistance in Enterobacteriaceae is associated with tolerance against antimicrobial peptides.

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Section: Discussionmentioning

confidence: 99%

Effect of antimicrobial peptides on colistin-susceptible and colistin-resistant strains of Klebsiella pneumoniae and Enterobacter asburiae

Kádár

Kocsis

Kristóf³

et al. 2015

Acta Microbiologica et Immunologica Hungarica

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“…Microbroth plates When synergy was detected by CB, a time-kill assay (TKA) was performed at 1xMIC following a previously published method (8). When MICs were above the therapeutic level, SXT was used at 8 mg/L and colistin at 4 mg/L, which fits the peak serum levels of these agents (9). Twenty ml of SXT, colistin and SXT-plus-colistin containing MuellerHinton II broth were inoculated with bacteria to yield a density of 106 CFU/mL in the final volume.…”

Section: Methodsmentioning

confidence: 99%

In Vitro Activity of Colistin and Trimethoprim/Sulfamethoxazole Against Consortia of Multidrug Resistant Non-Fermenting Gram-Negative Bacilli Isolated from Lower Respiratory Tract

Juhász

Kovács

Pongrácz

et al. 2017

Jundishapur J Microbiol

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Background: Multidrug resistant (MDR) Pseudomonas aeruginosa, Acinetobacter baumannii and Stenotrophomonas maltophilia have a leading role in nosocomial infections, including lower respiratory tract (LRT) infections. When polymicrobial infection by these three bacteria occurs, colistin against MDR P. aeruginosa and A. baumannii and trimethoprim/sulfamethoxazole (SXT) against S. maltophilia can be an optional antimicrobial strategy. Objectives: The aim of this study was to investigate the potential synergic effect of colistin-plus-SXT against those MDR P. aeruginosa, A. baumannii and S. maltophilia isolates that were isolated at the same time, from the same LRT sample of patients. Methods: Sixty connected isolates from 20 different patients were collected in a two-year study period. The checkerboard method and time-kill assays were used for synergy testing. Results: All P. aeruginosa and A. baumannii strains were susceptible to colistin, whereas all S. maltophilia isolates were resistant to it. Fifteen percent of MDR A. baumannii strains and all S. maltophilia isolates were susceptible to SXT. By the checkerboard method, colistin-plus-SXT showed synergy in 50%, 35% and 45% of S. maltophilia, MDR P. aeruginosa and MDR A. baumannii strains, respectively. Antagonistic effect was not found. A time-kill assay was performed on strains which showed synergy by the checkerboard method: 70%, 57% and 56% of S. maltophilia, P. aeruginosa and A. baumannii strains showed the same results. Synergic activity of the combination was already detected after 6 h incubation in 86% of S. maltophilia isolates and 50% of P. aeruginosa strains. Regrowth of A. baumannii after 24 hour in the presence of colistin was prevented by the combination. The results gained by CB and TKA methods

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“…Эффект потенцирования антибактериальной актив ности колистина антибиотиками, не способными в обыч ных условиях проникать через наружную мембрану грамотрицательных бактерий к внутриклеточным ми шеням, заслуживает более детального изучения в отно шении различных видов энтеробактерий и грамотрица тельных неферментирующих бактерий с множественной и экстремальной антибиотикорезис тентностью. В ряде работ показана способность колистина потенцировать активность АМП, действующих на внутриклеточные ми шени (рифампицина, триметоприма, гликопептидов и фторхинолонов) в отношении колистинорезистентных K. pneumoniae, A. baumannii и P. aeruginosa [15][16][17]. Ограничением указанных исследований являлось изу чение преимущественно лабораторных колистинорези стентных мутантов и реципиентов mcr1несущих плаз мид, а также небольшое количество исследованных колистинорезистентных клинических изолятов, что мо жет быть связано с тем, что они относительно низко представлены в бактериальных популяциях, а также со значительной трудоемкостью использованных ме тодов.…”

Section: Discussionunclassified

Potentiation of antimicrobial activity of colistin with antibiotics of different groups against multidrug- and extensively drug-resistant strains of Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa

Tapalskiy

Petrovskaya

Козлова

et al. 2020

CMAC

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Objective. To reveal antibiotics being capable of potentiating the antimicrobial activity of colistin against multidrug- and extensively drug-resistant strains of Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa. Materials and Methods. The minimum inhibitory concentrations (MIC) of colistin alone and in combination with fixed concentrations of antibiotics of different groups were determined for 272 multidrug- and extensively drug-resistant strains of K. pneumoniae, A. baumannii and P. aeruginosa. Bactericidal activity of colistin, carbapenems, clarithromycin and their combinations were also determined at fixed PK/PD breakpoint concentrations of antibiotics. Results. Potentiation of colistin antibacterial activity in the presence of fixed concentration of rifampicin (0.5 mg/L) was observed as a 4–16-fold MIC decrease for K. pneumoniae and A. baumannii. In the presence of fixed concentrations of azithromycin (2 mg/L) or clarithromycin (1 mg/L), the colistin MICs decreased 64–512 times for K. pneumoniae, 4–32 times for A. baumannii, 16–64 times for P. aeruginosa. Two- or more-fold reduction of MIC of colistin in the presence of 1 mg/L clarithromycin was observed for 85.2% of K. pneumoniae, 86.3% of A. baumannii and 60.2% of P. aeruginosa strains. In the presence of 1 mg/L clarithromycin and 8 mg/L meropenem, the potentiation effect was enhanced and was observed for an even larger percent of isolates: 96.1% K. pneumoniae, 98.0% A. baumannii and 61.3% P. aeruginosa. Colistin-based combinations with clarithromycin-meropenem and clarithromycin-doripenem were bactericidal against most isolates of A. baumannii and P. aeruginosa (91.4–100%), and against colistin-sensitive K. pneumoniae (95.3%) and colistin-resistant K. pneumoniae (79.1%). Conclusions. The ability of macrolides to significantly potentiate the colistin antimicrobial activity against both colistin-sensitive and colistin-resistant strains of K. pneumoniae, A. baumannii and P. aeruginosa was shown. This potentiation effect was enhanced in the presence of carbapenems. The most potent bactericidal activity was revealed with dual and triple combinations of colistin-clarithromycin and colistinclarithromycin-carbapenems.

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Synergistic antibiotic combinations for colistin-resistantKlebsiella pneumoniae

Cited by 12 publications

References 25 publications

Effect of antimicrobial peptides on colistin-susceptible and colistin-resistant strains of Klebsiella pneumoniae and Enterobacter asburiae

Effect of antimicrobial peptides on colistin-susceptible and colistin-resistant strains of Klebsiella pneumoniae and Enterobacter asburiae

In Vitro Activity of Colistin and Trimethoprim/Sulfamethoxazole Against Consortia of Multidrug Resistant Non-Fermenting Gram-Negative Bacilli Isolated from Lower Respiratory Tract

Potentiation of antimicrobial activity of colistin with antibiotics of different groups against multidrug- and extensively drug-resistant strains of Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa

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