In vitro synergistic effects of antimicrobial combinations on extensively drug-resistant pseudomonas aeruginosa and acinetobacter baumannii isolates

Hyukmin Lee, Kyung Ho Roh, Seong Geun Hong, Hee Bong Shin, Seok Hoon Jeong, Wonkeun Song, Young Uh, Dongeun Yong, Kyungwon Lee

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Extensively drug-resistant (XDR) Pseudomonas aeruginosa and Acinetobacter baumannii are a threat to hospitalized patients. We evaluated the effects of antimicrobial combinations on XDR P. aeruginosa and A. baumannii isolates. Methods: P. aeruginosa and A. baumannii isolates, which were resistant to all antibiotics except colistin (CL), were collected from eight hospitals in Korea. Genes encoding metallo-β-lactamases (MBLs) and OXA carbapenemases were detected by PCR in eight P. aeruginosa and 30 A. baumannii isolates. In vitro synergy of antimicrobial combinations was tested by using the checkerboard method. Results: Minimum inhibitory concentrations of β-lactams, aminoglycosides, and fluoroquinolones were very high, while that of CL was low for majority of XDR P. aeruginosa and A. baumannii isolates. Antimicrobial combinations including Imipenem (IPM)-CL, ceftazidime (CAZ)-CL, and rifampin (RIF)-CL exerted only additive/indifferent effects on majority of XDR P. aeruginosa isolates. Proportions of XDR A. baumannii isolates that showed synergistic and additive/indifferent inhibition after treatment with antimicrobial combinations used are as follows: IPM-ampicillin-sulbactam (AMS), 17% and 80% isolates, respectively; IPM-rifampin (RIF), 13% and 81% isolates, respectively; IPM-CL, 13% and 87% isolates, respectively; and RIF-COL, 20% and 73% isolates, respectively. Significant proportion (19%) of XDR P. aeruginosa isolates produced MBLs, and majority (82%) of A. baumannii isolates produced either MBLs or OXA-23. Conclusions: Our results suggest that combinations of IPM-AMS, IPM-RIF, IPM-CL, and RIF-CL are more useful than individual drugs for treating 13-20% of XDR A. baumannii infections.

Original languageEnglish
Pages (from-to)138-144
Number of pages7
JournalAnnals of laboratory medicine
Volume36
Issue number2
DOIs
Publication statusPublished - 2016 Mar

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Colistin
Acinetobacter baumannii
Imipenem
Pseudomonas aeruginosa
Rifampin
Pharmaceutical Preparations
Acinetobacter Infections
Lactams
Gene encoding
Ceftazidime
In Vitro Techniques
Fluoroquinolones
Microbial Sensitivity Tests
Aminoglycosides
Korea
Anti-Bacterial Agents
Polymerase Chain Reaction

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

@article{d601d84b0790456f9a2e272bb46266f7,
title = "In vitro synergistic effects of antimicrobial combinations on extensively drug-resistant pseudomonas aeruginosa and acinetobacter baumannii isolates",
abstract = "Background: Extensively drug-resistant (XDR) Pseudomonas aeruginosa and Acinetobacter baumannii are a threat to hospitalized patients. We evaluated the effects of antimicrobial combinations on XDR P. aeruginosa and A. baumannii isolates. Methods: P. aeruginosa and A. baumannii isolates, which were resistant to all antibiotics except colistin (CL), were collected from eight hospitals in Korea. Genes encoding metallo-β-lactamases (MBLs) and OXA carbapenemases were detected by PCR in eight P. aeruginosa and 30 A. baumannii isolates. In vitro synergy of antimicrobial combinations was tested by using the checkerboard method. Results: Minimum inhibitory concentrations of β-lactams, aminoglycosides, and fluoroquinolones were very high, while that of CL was low for majority of XDR P. aeruginosa and A. baumannii isolates. Antimicrobial combinations including Imipenem (IPM)-CL, ceftazidime (CAZ)-CL, and rifampin (RIF)-CL exerted only additive/indifferent effects on majority of XDR P. aeruginosa isolates. Proportions of XDR A. baumannii isolates that showed synergistic and additive/indifferent inhibition after treatment with antimicrobial combinations used are as follows: IPM-ampicillin-sulbactam (AMS), 17{\%} and 80{\%} isolates, respectively; IPM-rifampin (RIF), 13{\%} and 81{\%} isolates, respectively; IPM-CL, 13{\%} and 87{\%} isolates, respectively; and RIF-COL, 20{\%} and 73{\%} isolates, respectively. Significant proportion (19{\%}) of XDR P. aeruginosa isolates produced MBLs, and majority (82{\%}) of A. baumannii isolates produced either MBLs or OXA-23. Conclusions: Our results suggest that combinations of IPM-AMS, IPM-RIF, IPM-CL, and RIF-CL are more useful than individual drugs for treating 13-20{\%} of XDR A. baumannii infections.",
author = "Hyukmin Lee and Roh, {Kyung Ho} and Hong, {Seong Geun} and Shin, {Hee Bong} and Jeong, {Seok Hoon} and Wonkeun Song and Young Uh and Dongeun Yong and Kyungwon Lee",
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In vitro synergistic effects of antimicrobial combinations on extensively drug-resistant pseudomonas aeruginosa and acinetobacter baumannii isolates. / Lee, Hyukmin; Roh, Kyung Ho; Hong, Seong Geun; Shin, Hee Bong; Jeong, Seok Hoon; Song, Wonkeun; Uh, Young; Yong, Dongeun; Lee, Kyungwon.

In: Annals of laboratory medicine, Vol. 36, No. 2, 03.2016, p. 138-144.

Research output: Contribution to journalArticle

TY - JOUR

T1 - In vitro synergistic effects of antimicrobial combinations on extensively drug-resistant pseudomonas aeruginosa and acinetobacter baumannii isolates

AU - Lee, Hyukmin

AU - Roh, Kyung Ho

AU - Hong, Seong Geun

AU - Shin, Hee Bong

AU - Jeong, Seok Hoon

AU - Song, Wonkeun

AU - Uh, Young

AU - Yong, Dongeun

AU - Lee, Kyungwon

PY - 2016/3

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N2 - Background: Extensively drug-resistant (XDR) Pseudomonas aeruginosa and Acinetobacter baumannii are a threat to hospitalized patients. We evaluated the effects of antimicrobial combinations on XDR P. aeruginosa and A. baumannii isolates. Methods: P. aeruginosa and A. baumannii isolates, which were resistant to all antibiotics except colistin (CL), were collected from eight hospitals in Korea. Genes encoding metallo-β-lactamases (MBLs) and OXA carbapenemases were detected by PCR in eight P. aeruginosa and 30 A. baumannii isolates. In vitro synergy of antimicrobial combinations was tested by using the checkerboard method. Results: Minimum inhibitory concentrations of β-lactams, aminoglycosides, and fluoroquinolones were very high, while that of CL was low for majority of XDR P. aeruginosa and A. baumannii isolates. Antimicrobial combinations including Imipenem (IPM)-CL, ceftazidime (CAZ)-CL, and rifampin (RIF)-CL exerted only additive/indifferent effects on majority of XDR P. aeruginosa isolates. Proportions of XDR A. baumannii isolates that showed synergistic and additive/indifferent inhibition after treatment with antimicrobial combinations used are as follows: IPM-ampicillin-sulbactam (AMS), 17% and 80% isolates, respectively; IPM-rifampin (RIF), 13% and 81% isolates, respectively; IPM-CL, 13% and 87% isolates, respectively; and RIF-COL, 20% and 73% isolates, respectively. Significant proportion (19%) of XDR P. aeruginosa isolates produced MBLs, and majority (82%) of A. baumannii isolates produced either MBLs or OXA-23. Conclusions: Our results suggest that combinations of IPM-AMS, IPM-RIF, IPM-CL, and RIF-CL are more useful than individual drugs for treating 13-20% of XDR A. baumannii infections.

AB - Background: Extensively drug-resistant (XDR) Pseudomonas aeruginosa and Acinetobacter baumannii are a threat to hospitalized patients. We evaluated the effects of antimicrobial combinations on XDR P. aeruginosa and A. baumannii isolates. Methods: P. aeruginosa and A. baumannii isolates, which were resistant to all antibiotics except colistin (CL), were collected from eight hospitals in Korea. Genes encoding metallo-β-lactamases (MBLs) and OXA carbapenemases were detected by PCR in eight P. aeruginosa and 30 A. baumannii isolates. In vitro synergy of antimicrobial combinations was tested by using the checkerboard method. Results: Minimum inhibitory concentrations of β-lactams, aminoglycosides, and fluoroquinolones were very high, while that of CL was low for majority of XDR P. aeruginosa and A. baumannii isolates. Antimicrobial combinations including Imipenem (IPM)-CL, ceftazidime (CAZ)-CL, and rifampin (RIF)-CL exerted only additive/indifferent effects on majority of XDR P. aeruginosa isolates. Proportions of XDR A. baumannii isolates that showed synergistic and additive/indifferent inhibition after treatment with antimicrobial combinations used are as follows: IPM-ampicillin-sulbactam (AMS), 17% and 80% isolates, respectively; IPM-rifampin (RIF), 13% and 81% isolates, respectively; IPM-CL, 13% and 87% isolates, respectively; and RIF-COL, 20% and 73% isolates, respectively. Significant proportion (19%) of XDR P. aeruginosa isolates produced MBLs, and majority (82%) of A. baumannii isolates produced either MBLs or OXA-23. Conclusions: Our results suggest that combinations of IPM-AMS, IPM-RIF, IPM-CL, and RIF-CL are more useful than individual drugs for treating 13-20% of XDR A. baumannii infections.

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