In-vitro activity of polymyxin B in combination with imipenem, rifampicin and azithromycin versus multidrug resistant strains of Acinetobacter baumannii producing OXA-23 carbapenemases.

Annals of Clinical Microbiology and Antimicrobials
D W Wareham, David C Bean

Abstract

Acinetobacter baumannii has emerged as a major nosocomial pathogen worldwide. Many of the circulating strains exhibit multi-drug resistance remaining consistently susceptible only to polymyxins. In-vitro studies have reported that polymyxins combined with carbapenems, rifampicin or azithromycin are synergistic against these strains despite in-vitro resistance to these agents alone. The use of antimicrobial combinations have therefore been advocated for the treatment of severe A. baumannii infection in man. In order to determine whether such combinations are synergistic against the prevalent clones of multi-drug resistant A. baumannii causing infection in the UK, we performed synergy testing against representative isolates using two rapid Etest methods. The activity of polymyxin in combination with imipenem, azithromycin or rifampicin was assessed against five strains of multi-drug resistant A. baumannii encoding OXA-23 carbapenemases. Synergy studies were performed by Etest-agar dilution and a combined Etest strip method. Synergy was defined as a FICI of < or = 0.5. All strains were resistant to beta-lactams, carbapenems, quinolones and aminoglycosides but susceptible to polymyxins. Marked synergy was not seen with polymyxin in...Continue Reading

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Citations

Oct 9, 2009·Epidemiology and Infection·S M SuepaulA A Adesiyun
Jun 12, 2013·Antimicrobial Agents and Chemotherapy·Carlo TasciniFrancesco Menichetti
Aug 24, 2011·Antimicrobial Agents and Chemotherapy·Krisztina M Papp-WallaceRobert A Bonomo
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Jul 30, 2015·Journal of Medical Microbiology·Felipe F TuonAlexandre B Merlini
Jan 15, 2015·The Journal of Antibiotics·Kwang-sun KimJae-Gu Pan
Aug 7, 2013·Antimicrobial Agents and Chemotherapy·Oren ZusmanMical Paul
Jan 17, 2008·Drugs·Jacob Gilad, Yehuda Carmeli
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Feb 7, 2018·Indian Journal of Medical Microbiology·Shakti LaishramBalaji Veeraraghavan

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