In vitro activity of combinations of colistin with rifampicin, meropenem and ampicillin-sulbactam against colistin-resistant Acinetobacter clinical isolates

سال انتشار: 1397
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 371

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شناسه ملی سند علمی:

ICCM12_004

تاریخ نمایه سازی: 1 دی 1397

چکیده مقاله:

Introduction:Increasing use of colistin in a clinical setting had resulted in the emergence of colistin-resistant Acinetobacter species. Combination therapy may be the only viable option to treat infections caused by colistin-resistant Acinetobacter spp. until new antibiotics become available. The aim of current study was to identify potential antimicrobial combinations against colistin-resistant Acinetobacter species in order to reduce the need for high doses of antibiotics in therapy.Materials and methods:162 Acinetobacter strains were collected from patients of two hospitals in Kerman, Iran. For all Acinetobacter isolates Minimum inhibitory concentration (MIC) of Colistin was measured by broth microdilution method according to the CLSI guidelines. For colistin-resistant Acinetobacter isolates meropenem, ampicillin-sulbactam and rifampicin MIC was also determined. Checkerboard assay was then performed to assess synergistic effects, in 96-well microliter plates containing colistin and 1 of 3 other antibiotics. The synergistic potential of the combinations was determined by the Fractional Inhibitory Concentration Index (FICI).Results:Among the 162 isolates, seven of the strains were resistant to colistin. The greatest amount of synergy occurred with the colistin - rifampicin combination in which synergism was present with all colistin resistant strains. Synergy for the combination of colistin with meropenem and colistin with ampicillin-sulbactam was observed in 6 and 5 isolates respectively. Conclusion:The current investigation demonstrated that combination therapy with colistin and rifampicin had a significantly more favorable antimicrobial activity on colistin resistant Acinetobacter isolates. Combination could be clinically useful and potentially be decreasing colistin toxicity related to higher concentrations used in colistin monotherapy.

نویسندگان

Ali Golabi Dehdasht

Department of Microbiology and Virology, Afzalipour School of Medicine, Kerman, Iran

Hosein Hoseini Naveh

Department of Microbiology and Virology, Afzalipour School of Medicine, Kerman, Iran