Colistin-sparing regimens against Klebsiella pneumoniae carbapenemase-producing K. pneumoniae isolates: Combination of tigecycline or doxycycline and gentamicin or amikacin

Tang, Hung Jen; Lai, Chih Cheng; Chen, Chi Chung; Zhang, Chun Cheng; Weng, Tzu Chieh; Chiu, Yu Hsin; Toh, Han Siong; Chiang, Shyh Ren; Yu, Wen Liang; Ko, Wen Chien; Chuang, Yin Ching

doi:10.1016/j.jmii.2016.03.003

Cited by 24 publications

(22 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recurrent UTIs typically are not life-threatening, but the high frequency increases health-care costs and has negative impacts on patients’ life quality. Importantly, combination of ceragenins with LL-37 peptide presented in this study shows stronger intracellular activity against uropathogenic E. coli than both agents alone, which is in agreement with other studies clearly indicating that combinatory therapy is more efficient in eradication of multi-drug resistant (MDR) bacterial infections when compared with monotherapy [38].…”

Section: Discussionsupporting

confidence: 92%

“…Tetracyclines are a class of widely used antibiotics with broad-spectrum activity against both Gram-positive and Gram-negative bacteria, as well as against intracellular organisms [37], and doxycycline, a tetracycline antimicrobial, has been identified as an option for treatment of [9]. Importantly, Tang et al showed that antimicrobial activity of DOX against Klebsiella pneumoniae carbapenemase (KPC) isolates might be additionally enhanced by combining doxycycline with gentamicin/amikacin [38]. Jernigan et al also showed that combination therapy of doxycycline with gentamicin was more effective against KPC-producing isolates than monotherapy [39].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of ceragenins as a potential treatment for urinary tract infections

et al. 2019

View full text Add to dashboard Cite

Background Urinary tract infections (UTIs) are one of the most common bacterial infections. High recurrence rates and the increasing antibiotic resistance among uropathogens constitute a large social and economic problem in current public health. We assumed that combination of treatment that includes the administration ceragenins (CSAs), will reinforce the effect of antimicrobial LL-37 peptide continuously produced by urinary tract epithelial cells. Such treatment might be an innovative approach to enhance innate antibacterial activity against multidrug-resistant E. coli . Methods Antibacterial activity measured using killing assays. Biofilm formation was assessed using crystal violet staining. Viability of bacteria and bladder epithelial cells subjected to incubation with tested agents was determined using MTT assays. We investigated the effects of chosen molecules, both alone and in combinations against four clinical strains of E. coli, obtained from patients diagnosed with recurrent UTI. Results We observed that the LL-37 peptide, whose concentration increases at sites of urinary infection, exerts increased bactericidal effect against E. coli when combined with ceragenins CSA-13 and CSA-131. Conclusion We suggest that the employment of combination of natural peptide LL-37 with synthetic analogs might be a potential solution to treat urinary tract infections caused by drug-resistant bacteria.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Use of ceragenins as a potential treatment for urinary tract infections

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Twenty clinical strains, including 10 different pulse field gel electrophoresis (PFGE) genotyped carbapenem-resistant Escherichia coli (CREC) and Klebsiella pneumoniae (CRKP) strains were isolated from Chi Mei Medical Center (Lai et al, 2016; Tang et al, 2016b). Species confirmations were performed using the VITEK 2 automated system (bioMérieux, Marcy l’Etoile, France) with standard biochemical methods.…”

Section: Methodsmentioning

confidence: 99%

Antimicrobial Activity of Lactobacillus Species Against Carbapenem-Resistant Enterobacteriaceae

et al. 2019

Self Cite

View full text Add to dashboard Cite

Objective This study aims to identify suitable lactobacilli that have anti-carbapenem-resistant Enterobacteriaceae (CRE) activity with in vitro tolerance to pepsin and bile salts. Methods Fifty-seven Lactobacillus spp. strains encompassing nine species were collected for investigation. Their viabilities in the presence of pepsin and bile salts were tested using tolerance tests. Their anti-CRE effects were assessed by agar well diffusion and broth microdilution assay, as well as time-kill test. Results Of the 57 Lactobacillus isolates collected, 31 had a less than 2-log reduction in their viability in both pepsin and bile salt tolerance tests. Of these 31 isolates, 5 (LUC0180, LUC0219, LYC0289, LYC0413, and LYC1031) displayed the greatest anti-CRE activity with a CRE zone of inhibition greater than 15 mm in agar well diffusion assays. The minimal inhibitory percentages of supernatants from these five strains against CREs ranged from 10 to 30%. With the exception of LUC0180, which had a minimal bactericidal percentage ≥ 40%, the bactericidal percentage of all the strains ranged from 20 to 40%. The inhibitory effect of the cell-free culture supernatants from these Lactobacillus strains did not change after heating but was abolished as the pH changed to 7.0. After a 24-h incubation, five of the Lactobacillus strains at a concentration of 10 8 CFU/ml totally inhibited the growth of carbapenem-resistant Escherichia coli (CRE316) and Klebsiella pneumoniae (CRE632). After a 48-h incubation, the growth of CRE316 was completely inhibited under each concentration of lactobacilli based on time-kill test. Furthermore, when the concentration of lactobacilli was at 10 8 CFU/ml, the decline in pH was faster than at other concentrations. Conclusion Some Lactobacillus strains exhibit anti-CRE activity, which suggests potential applications for controlling or preventing CRE colonization or infection.

show abstract

“…However, resistance to these antibiotics is increasing (Capone et al, 2013; Giacobbe et al, 2015; Yang et al, 2018). In addition to polymyxins and tigecycline, fosfomycin and aminoglycosides are occasionally used (Tang et al, 2016; Tseng et al, 2017; Rodriguez-Bano et al, 2018). Carbapenems still play a role in the treatment of CRE infections, particularly when used in the treatment of CRE with lower MICs, either in higher doses, in combination with other active anti-CRE agents, or through double-carbapenem therapy (DCT).…”

Section: Introductionmentioning

confidence: 99%

Infections Caused by Carbapenem-Resistant Enterobacteriaceae: An Update on Therapeutic Options

et al. 2019

View full text Add to dashboard Cite

Carbapenems are considered as last-resort antibiotics for the treatment of infections caused by multidrug-resistant Gram-negative bacteria. With the increasing use of carbapenems in clinical practice, the emergence of carbapenem-resistant pathogens now poses a great threat to human health. Currently, antibiotic options for the treatment of carbapenem-resistant Enterobacteriaceae (CRE) are very limited, with polymyxins, tigecycline, fosfomycin, and aminoglycosides as the mainstays of therapy. The need for new and effective anti-CRE therapies is urgent. Here, we describe the current understanding of issues related to CRE and review combination therapeutic strategies for CRE infections, including high-dose tigecycline, high-dose prolonged-infusion of carbapenem, and double carbapenem therapy. We also review the newly available antibiotics which have potential in the future treatment of CRE infections: ceftazidime/avibactam, which is active against KPC and OXA-48 producers; meropenem/vaborbactam, which is active against KPC producers; plazomicin, which is a next-generation aminoglycoside with in vitro activity against CRE; and eravacycline, which is a tetracycline class antibacterial with in vitro activity against CRE. Although direct evidence for CRE treatment is still lacking and the development of resistance is a concern, these new antibiotics provide additional therapeutic options for CRE infections. Finally, we review other potential anti-CRE antibiotics in development: imipenem/relebactam and cefiderocol. Currently, high-dose and combination strategies that may include the new β-lactam/β-lactamase inhibitors should be considered in severe CRE infections to maximize treatment success. In the future, when more treatment options are available, therapy for CRE infections should be individualized and based on molecular phenotypes of resistance, susceptibility profiles, disease severity, and patient characteristics. More high-quality studies are needed to guide effective treatment for infections caused by CRE.

show abstract

Colistin-sparing regimens against Klebsiella pneumoniae carbapenemase-producing K. pneumoniae isolates: Combination of tigecycline or doxycycline and gentamicin or amikacin

Abstract: Enhanced activity was noted following treatment with doxycycline combined with gentamicin or amikacin against KPC-producing K. pneumoniae isolates, warranting further in vitro and animal investigations before clinical application.

Cited by 24 publications

References 31 publications

Use of ceragenins as a potential treatment for urinary tract infections

Use of ceragenins as a potential treatment for urinary tract infections

Antimicrobial Activity of Lactobacillus Species Against Carbapenem-Resistant Enterobacteriaceae

Infections Caused by Carbapenem-Resistant Enterobacteriaceae: An Update on Therapeutic Options

Contact Info

Product

Resources

About