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 β-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 × 105 CFU/mL by using 1/2× MIC for each alone, and both 1/2× and 1/4× 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× MIC and 1/4× MIC, 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× MIC and 1/4× 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.
Original language | English |
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Pages (from-to) | 931-939 |
Number of pages | 9 |
Journal | Journal of Microbiology, Immunology and Infection |
Volume | 50 |
Issue number | 6 |
DOIs | |
Publication status | Published - Dec 2017 |
Keywords
- Carbapenem resistance
- Colistin
- ESBL
- Fosfomycin
- Tigecycline
ASJC Scopus subject areas
- Immunology and Allergy
- General Immunology and Microbiology
- Microbiology (medical)
- Infectious Diseases