‘Break-point Checkerboard Plate’ for screening of appropriate antibiotic combinations against multidrug-resistant Pseudomonas aeruginosa

Tateda, Kazuhiro; Ishii, Yoshikazu; Matsumoto, Tetsuya; Yamaguchi, Keizo

doi:10.1080/00365540500440353

Cited by 35 publications

(6 citation statements)

References 28 publications

(18 reference statements)

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“…Tateda et al reported using a breakpoint checkerboard plate method on 12 P. aeruginosa isolates tested with imipenem and polymyxin B, with all 12 isolates showing synergy (12). Three studies (13)(14)(15) reported using the area under the bacterial killing curve (AUBKC) against P. aeruginosa, K. pneumoniae, or A. baumannii.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of In Vitro Synergy of Polymyxins and Carbapenems

Zusman

Avni

Leibovici

et al. 2013

Antimicrob Agents Chemother

216

170

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e Our objective was to examine the evidence of in vitro synergy of polymyxin-carbapenem combination therapy against Gramnegative bacteria (GNB). A systematic review and meta-analysis were performed. All studies examining in vitro interactions of antibiotic combinations consisting of any carbapenem with colistin or polymyxin B against any GNB were used. A broad search was conducted with no language, date, or publication status restrictions. Synergy rates, defined as a fractional inhibitory concentration index of <0.5 or a >2-log reduction in CFU, were pooled separately for time-kill, checkerboard, and Etest methods in a mixed-effect meta-analysis of rates. We examined whether the synergy rate depended on the testing method, type of antibiotic, bacteria, and resistance to carbapenems. Pooled rates with 95% confidence intervals (CI) are shown. Thirty-nine published studies and 15 conference proceeding were included, reporting on 246 different tests on 1,054 bacterial isolates. In time-kill studies, combination therapy showed synergy rates of 77% (95% CI, 64 to 87%) for Acinetobacter baumannii, 44% (95% CI, 30 to 59%) for Klebsiella pneumoniae, and 50% (95% CI, 30 to 69%) for Pseudomonas aeruginosa, with low antagonism rates for all. Doripenem showed high synergy rates for all three bacteria. For A. baumannii, meropenem was more synergistic than imipenem, whereas for P. aeruginosa the opposite was true. Checkerboard and Etest studies generally reported lower synergy rates than time-kill studies. The use of combination therapy led to less resistance development in vitro. The combination of a carbapenem with a polymyxin against GNB, especially A. baumannii, is supported in vitro by high synergy rates, with low antagonism and less resistance development. These findings should be examined in clinical studies.

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Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of In Vitro Synergy of Polymyxins and Carbapenems

Zusman

Avni

Leibovici

et al. 2013

Antimicrob Agents Chemother

216

170

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“…Therefore, numerous plates are required when investigating various drugs simultaneously. In contrast, the "Break-point Checkerboard Plate," which was designed by Tateda et al in 2006, incorporates only two concentrations of eight antimicrobials near the breakpoints. By employing this novel method, we could evaluate three or four consecutive concentrations close to the CLSI breakpoints for each drug.…”

Section: Discussionmentioning

confidence: 99%

“…Among several methods of investigating in vitro efficacy of drugs in combination, the checkerboard method is most widely used because of its low cost and labor requirements (Odds, 2003). Further, the "Break-point Checkerboard Plate" allows for the simultaneous evaluation of 19 different combinations of drugs at clinically relevant concentrations on a single 96well microplate (Tateda et al, 2006). Recently, this technique has proven useful in daily clinical practice as a screening method for drug combinations exhibiting in vitro combined efficacy on multi-drug resistant Pseudomonas (MDRP) in Japan (Nishio et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

In vitro efficacy of combinations of eight antimicrobial agents against Mycobacteroides abscessus complex

Shirata

Yoshimoto²,

Marumo

et al. 2020

International Journal of Infectious Diseases

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A standard treatment regimen against Mycobacteroides abscessus complex (MABC) infections has not yet been established, making MABC difficult to treat successfully. In this study, we sought to develop an active ingredient for the clinical treatment of MABC infections. Methods: We screened 102 MABC strains isolated from clinical specimens using DNA sequence analysis with the housekeeping genes hsp65 and rpoB. Drug susceptibility testing was performed against two subspecies-Mycobacteroides abscessus subsp. abscessus (M. abscessus) and Mycobacteroides abscessus subsp. massiliense (M. massiliense)-using eight antimicrobial agents (clarithromycin, amikacin, doxycycline, imipenem, linezolid, moxifloxacin, faropenem, and rifampicin). The combined efficacy of the antimicrobial agents was investigated using a checkerboard method. Results: We identified 51 isolates as M. abscessus, 46 as M. massiliense, and five as others. Most of the M. abscessus isolates (83.0 %) exhibited inducible resistance to clarithromycin via the expression of the erm (41) gene. Combinations of imipenem with linezolid, moxifloxacin, and rifampicin exhibited additive effects against 81.0 %, 40.7 %, and 26.9 % of M. abscessus, respectively, and against 54.5 %, 69.2 %, and 30.8 % of M. massiliense, respectively. Conclusions: These results demonstrated the potential efficacy of a regimen containing imipenem against M. abscessus and M. massiliense infections.

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“…Therefore, appropriate antibiotic treatment using prolonged bacterial surveillance culture should be considered, particularly in ATL patients with persistent compromised cellular immunity. Moreover, because of a limitation of treatment active on multi-drug resistant gram negative rods, particularly Pseudomonas aeruginosa, at the present situation, the introduction of new treatment options, including antibiotic combination therapy using a "break-point checker board plate" and developing antibiotic agents such as colistin [58][59][60][61][62], are expected in patients who developed such infection after allo-SCT. Our results showed the higher risk of fatal infectious complications in post-transplant patients with ATL.…”

Section: Discussionmentioning

confidence: 99%

Distinct Clinical Features of Infectious Complications in Adult T Cell Leukemia/Lymphoma Patients after Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Analysis in the Nagasaki Transplant Group

Itonaga

Taguchi

Fukushima

et al. 2013

Biology of Blood and Marrow Transplantation

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Although allogeneic hematopoietic stem cell transplantation (allo-SCT) is performed as a curative option in adult T cell leukemia-lymphoma (ATL) patients, its high transplantation-related mortality raises a serious issue. The clinical features of infectious complications after transplantation are not well known. To analyze the impact of infections after allo-SCT for ATL, we retrospectively compared infectious complications in 210 patients at 3 institutions in Nagasaki prefecture between 1997 and 2009. There were 91 patients with acute myeloid leukemia (AML), 51 with acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL/LBL), and 68 with ATL. No patient received ganciclovir or foscarvir as prophylaxis, and most patients received antifungal prophylaxis with fluconazole or itraconazole. The cumulative incidence of cytomegalovirus (CMV) infection at 3 years was 69.2% in ATL patients versus 54.4% in AML patients (P = .0255). Cumulative infection-related mortality was significantly higher in ATL patients than in the 2 other groups (ATL versus AML, P = .0496; ATL versus ALL/LBL, P = .0075), and most death-causing pathogens were bacteria and fungus. The appearance of CMV infection was negatively associated with infectious mortality in ATL patients, but the P value for this association was near the borderline of significance (P = .0569). In multivariate analysis, transplantation using unrelated bone marrow and episodes of CMV infection were associated with worse overall survival in ATL patients, but were not in either AML or ALL/LBL patients. Collectively, the impact of infectious complications after transplantation in ATL patients was different from that in AML and ALL/LBL patients, suggesting that a more intensive strategy for infection control in ATL patients is required to reduce infectious mortality.

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‘Break-point Checkerboard Plate’ for screening of appropriate antibiotic combinations against multidrug-resistant Pseudomonas aeruginosa

Cited by 35 publications

References 28 publications

Systematic Review and Meta-Analysis of In Vitro Synergy of Polymyxins and Carbapenems

Systematic Review and Meta-Analysis of In Vitro Synergy of Polymyxins and Carbapenems

In vitro efficacy of combinations of eight antimicrobial agents against Mycobacteroides abscessus complex

Distinct Clinical Features of Infectious Complications in Adult T Cell Leukemia/Lymphoma Patients after Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Analysis in the Nagasaki Transplant Group

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