Synergy testing of multidrug resistant Acinetobacter baumanii against tigecycline and polymyxin using an E-test methodology

Sands, Michael; McCarter, Yvette S.; Sánchez, Walter

doi:10.1007/s10096-007-0330-4

Cited by 20 publications

(13 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They also detected a synergistic effect with tigecycline in combination with polymyxin B. Giske et al [51] also observed an indifferent interaction with the combination of tigecycline with colistin against carbapenem-resistant isolates of A. baumannii-calcoaceticus by Etest. In addition, using the same method, indifference was reported by Sands et al [53] with the combination of tigecycline and polymyxin B. Indifference (P > 0.05 compared with each drug tested alone) against an A. baumannii isolate was also observed in a biofilm-associated vascular catheter model in vitro with the combination of tigecycline with N-acetylcysteine [48].…”

Section: Gram-negative Organismssupporting

confidence: 65%

Tigecycline in combination with other antimicrobials: a review of in vitro, animal and case report studies

Entenza

Moreillon

2009

International Journal of Antimicrobial Agents

View full text Add to dashboard Cite

Section: Gram-negative Organismssupporting

confidence: 65%

Tigecycline in combination with other antimicrobials: a review of in vitro, animal and case report studies

Entenza

Moreillon

2009

International Journal of Antimicrobial Agents

View full text Add to dashboard Cite

“…There are several reports in the literature of synergy studies performed with multidrug-resistant Acinetobacter baumannii (14,15,19). However, the synergy findings were not universal and may have been strain dependent (17), making it difficult to generalize the results.…”

Section: Discussionmentioning

confidence: 99%

“…There is some literature exploring combination antimicrobial therapy in the treatment of multidrug-resistant strains of Acinetobacter baumannii and Pseudomonas aeruginosa (8,14,15,17,19,21). However, there are limited data on combination therapy for KPC-producing K. pneumoniae.…”

mentioning

confidence: 99%

In Vitro Evaluation of Antibiotic Synergy for Polymyxin B-Resistant Carbapenemase-Producing Klebsiella pneumoniae

Elemam¹,

Rahimian²,

Doymaz

2010

J Clin Microbiol

116

View full text Add to dashboard Cite

Since carbapenemase-producing Klebsiella pneumoniae strains were first reported in North Carolina, these highly resistant organisms have been isolated with increasing frequency, especially in the New York City area. Polymyxin B is one of the few antimicrobials that retain reliable activity against these organisms. However, polymyxin B MICs are elevated against K. pneumoniae isolates with increasing frequency, leaving clinicians with few therapeutic options. We investigated several antimicrobial agents for potential synergy with polymyxin B against 12 clinical strains of carbapenemase-producing K. pneumoniae. A broth microdilution assay using a 96-well plate was developed in which graded dilutions of polymyxin B and the study drug were incubated with resistant isolates in a checkerboard pattern. Polymyxin B was studied in combination with cefazolin, ceftriaxone, cefepime, imipenem, gentamicin, tigecycline, doxycycline, and rifampin. All K. pneumoniae strains tested positive for K. pneumoniae carbapenemase (KPC) genes by real-time PCR and had elevated polymyxin B MIC values ranging from 16 to 128 g/ml. Synergy was observed with the combination of polymyxin B and rifampin as well as with polymyxin B and doxycycline, resulting in at least a 4-fold decrease in the polymyxin B MIC. For both combinations, this effect occurred at physiologically achievable concentrations. Less pronounced synergy was noted with tigecycline and polymyxin B. No synergy was observed at physiologic concentrations with the other antimicrobials studied. These results suggest that rifampin, doxycycline, and tigecycline may be useful additions to polymyxin B in the treatment of infections caused by highly resistant carbapenemaseproducing K. pneumoniae. Further studies are warranted to determine if these in vitro findings translate into clinical efficacy.

show abstract

“…Most studies have reported an MIC 50 of 1 g/ml and an MIC 90 of 2 g/ml (229,413,473), but studies from Germany (500), Spain (37), and Israel (389) have reported MIC 90 s of 4 g/ml, 8 g/ml, and 32 g/ml, respectively, with the last being determined by Etest only. More recently, combination therapy with tigecycline has been studied using time-kill and Etest synergy methodology (476,486). When it was tested against a noncarbapenem-susceptible A. baumannii strain, tigecycline alone allowed maximal killing at concentrations near the MIC, which was 1 g/ml, with no benefit of using higher concentrations (486).…”

Section: New Antimicrobialsmentioning

confidence: 99%

Acinetobacter baumannii : Emergence of a Successful Pathogen

2008

View full text Add to dashboard Cite

SUMMARY Acinetobacter baumannii has emerged as a highly troublesome pathogen for many institutions globally. As a consequence of its immense ability to acquire or upregulate antibiotic drug resistance determinants, it has justifiably been propelled to the forefront of scientific attention. Apart from its predilection for the seriously ill within intensive care units, A. baumannii has more recently caused a range of infectious syndromes in military personnel injured in the Iraq and Afghanistan conflicts. This review details the significant advances that have been made in our understanding of this remarkable organism over the last 10 years, including current taxonomy and species identification, issues with susceptibility testing, mechanisms of antibiotic resistance, global epidemiology, clinical impact of infection, host-pathogen interactions, and infection control and therapeutic considerations.

show abstract

Synergy testing of multidrug resistant Acinetobacter baumanii against tigecycline and polymyxin using an E-test methodology

Cited by 20 publications

References 11 publications

Tigecycline in combination with other antimicrobials: a review of in vitro, animal and case report studies

Tigecycline in combination with other antimicrobials: a review of in vitro, animal and case report studies

In Vitro Evaluation of Antibiotic Synergy for Polymyxin B-Resistant Carbapenemase-Producing Klebsiella pneumoniae

Acinetobacter baumannii : Emergence of a Successful Pathogen

Contact Info

Product

Resources

About