Colistin and anti-Gram-positive bacterial agents against Acinetobacter baumannii

Liu, Bin; Liu, You-ning; Di, Xiuzhen; Zhang, Xin; Wang, Rui; Bai, Yan; Wang, Jin

doi:10.1590/0037-8682-0081-2014

Cited by 36 publications

(24 citation statements)

References 19 publications

(24 reference statements)

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“…Three decades ago, A. baumannii infections were effectively treated with traditional antibiotics [7,8] . By contrast, it currently exerts resistance to nearly all major classes of antibiotics, including broad-spectrum penicillins, cephalosporins, carbapenems, most aminoglycosides, fluoroquinolones, chloramphenicol, and tetracyclines.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Resistance of Acinetobacter baumannii in Iran: A Systemic Review of the Published Literature

Moradi

Hashemi

Bahador

2015

Osong Public Health and Research Perspectives

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ObjectivesAcinetobacter baumannii is a bacterium responsible for health care-associated infections, and it frequently develops multiple drug resistance (MDR). The prevalence of antibiotic-resistant A. baumannii in Iran has increased, and this may cause significant clinical problems. Therefore, in order to elucidate the development of antibiotic resistance, we performed a systematic review of the literature published on antibiotic-resistant A. baumannii reported in Iran.MethodsThirty-six publications that met the criteria for inclusion were reviewed from an initial 87 papers. Selected papers published between 2008 and September 2014, were categorized on the basis of the sample collecting year been between 2001 and 2013.ResultsAnalysis of data revealed that, in general, there was an increase in antimicrobial resistance. During the initial time point of these studies (2001–2007) there was a high rate of resistance to all antibiotics, with the exception of carbapenems, lipopeptides, and aminoglycosides that had a low resistance rate in comparison with the others. Also, the resistance rate was increased in one group of these three antimicrobial groups from 2010 to 2013. In particular, there was an increase in resistance to carbapenems (imipenem and meropenem) from 2010–2011 and 2012–2013, whereas no significant change in the resistance rate of the other two antimicrobial groups (lipopeptides and aminoglycosides) during the study time was observed, although we did observe certain trends in amikacin (aminoglycoside group antibiotic) between 2011–2012 and 2012–2013.ConclusionThese findings indicate that antimicrobial resistance of A. baumannii in Iran has increased, which may very well affect the antimicrobial resistance of this organism worldwide. Based on these results, novel prevention and treatment strategies against A. baumannii infections are warranted. Furthermore, these data may assist in revising treatment guidelines and regional policies in care units to slow the emergence of antimicrobial resistance.

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Section: Introductionmentioning

confidence: 99%

Antibiotic Resistance of Acinetobacter baumannii in Iran: A Systemic Review of the Published Literature

Moradi

Hashemi

Bahador

2015

Osong Public Health and Research Perspectives

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“…Polymyxins act via an electrostatic interaction with lipopolysaccharide (LPS), disrupting the integrity of the Gram-negative outer membrane and promoting cell lysis. This may increase permeability to compounds that are usually excluded and is hypothesized to be the mechanism behind the synergy observed with glycopeptides and other hydrophobic antimicrobials (31). An inverse relationship between resistance to polymyxins and susceptibility to other antimicrobials has been reported (32).…”

Section: Discussionmentioning

confidence: 99%

Colistin and Fusidic Acid, a Novel Potent Synergistic Combination for Treatment of Multidrug-Resistant Acinetobacter baumannii Infections

Phee

Betts

Bharathan

et al. 2015

Antimicrob Agents Chemother

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bThe spread of multidrug-resistant Acinetobacter baumannii (MDRAB) has led to the renaissance of colistin (COL), often the only agent to which MDRAB remains susceptible. Effective therapy with COL is beset with problems due to unpredictable pharmacokinetics, toxicity, and the rapid selection of resistance. Here, we describe a potent synergistic interaction when COL was combined with fusidic acid (FD) against A. baumannii. Synergy in vitro was assessed against 11 MDRAB isolates using disc diffusion, checkerboard methodology (fractional inhibitory concentration index [FICI] of < 0.5, susceptibility breakpoint index [SBPI] of >2), and time-kill methodology (>2 log 10 CFU/ml reduction). The ability of FD to limit the emergence of COL resistance was assessed in the presence and absence of each drug alone and in combination. Synergy was demonstrated against all strains, with an average FICI and SBPI of 0.064 and 78.85, respectively. In time-kill assays, COL-FD was synergistic and rapidly bactericidal, including against COL-resistant strains. Fusidic acid prevented the emergence of COL resistance, which was readily selected with COL alone. This is the first description of a novel COL-FD regimen for the treatment of MDRAB. The combination was effective at low concentrations, which should be therapeutically achievable while limiting toxicity. Further studies are warranted to determine the mechanism underlying the interaction and the suitability of COL-FD as an unorthodox therapy for the treatment of multidrug-resistant Gram-negative infections. Infections due to the Gram-negative bacterium Acinetobacter baumannii are increasingly challenging to treat and control. The organism has emerged worldwide as a major nosocomial pathogen in critical care units responsible for bloodstream, respiratory, skin and soft tissue, and device-related infections (1). Clinical isolates are often resistant to multiple antimicrobial drugs and belong to successful epidemiologically defined clones that, once established, are extremely difficult to eradicate from the hospital environment (2). As a result, outbreaks are common, typically last for months, and may cost institutions in excess of $500,000 to curtail (3). Treatment of infected individuals is equally hampered by a seemingly endless capacity of the organism to acquire and maintain large numbers of antimicrobial resistance genes (4). Carbapenems, once considered the treatment of choice, are increasingly found to be ineffective, leaving polymyxins (polymyxin B and colistin [COL]) as the treatment of last resort (5).Although polymyxins have been widely employed in the treatment of A. baumannii infections, there are still concerns about their efficacy and safety. These include the unreliable methods for performing susceptibility testing, inadequate population pharmacokinetic data, uncertainties around appropriate dosing regimens, and the availability of the licensed formulations of colistin only as the inactive prodrug colistimethate sodium (6).Despite this, polymyxins have frequently been s...

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“…In this study, we explored possible synergies between CAMPs and antimicrobials lacking activity in Gram-negative bacteria [20,21]; specifically, the triple antimicrobial combination of colistin-rifampicin-linezolid. Greater activity of both colistin-rifampicin [9] and colistin-linezolid [20] than either rifampicin or linezolid alone has been reported. Based on previous reports of the ability of sublethal concentrations of colistin to permeabilize bacterial membranes, we tested colistin in combination with rifampicin and linezolid, two antimicrobials otherwise ineffective in treating E. coli infections.…”

Section: Discussionmentioning

confidence: 99%

When Combined with Colistin, an Otherwise Ineffective Rifampicin–Linezolid Combination Becomes Active in Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii

et al. 2020

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The synergistic action of colistin, with two antibiotics active in Gram-positive bacteria but unable to kill gram negatives (linezolid and rifampicin), was investigated, since triple combinations are emerging as a tool to overtake multidrug resistance. Checkerboard determinations demonstrated that, when combined with colistin, the combination of linezolid and rifampicin turns active in multidrug-resistant Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii. Thus, the presence of sublethal concentrations of colistin resulted in a strongly synergistic interaction between these two drugs. Moreover, the minimum inhibitory concentrations of linezolid–rifampicin combinations in the presence of colistin were lower than the maximal concentrations of these antimicrobials ain blood. These findings suggest the use of this triple combination as an effective treatment of multidrug-resistant (MDR) bacterial infections.

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Colistin and anti-Gram-positive bacterial agents against Acinetobacter baumannii

Cited by 36 publications

References 19 publications

Antibiotic Resistance of Acinetobacter baumannii in Iran: A Systemic Review of the Published Literature

Antibiotic Resistance of Acinetobacter baumannii in Iran: A Systemic Review of the Published Literature

Colistin and Fusidic Acid, a Novel Potent Synergistic Combination for Treatment of Multidrug-Resistant Acinetobacter baumannii Infections

When Combined with Colistin, an Otherwise Ineffective Rifampicin–Linezolid Combination Becomes Active in Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii

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