In-vitro activity of the combination of colistin and rifampicin against multidrug-resistant strains of Acinetobacter baumannii [published erratum appears in J Antimicrob Chemother 1998 Sep;42(3):413]

Hogg, G. M.; Barr, J. G.; Webb, C. H.

doi:10.1093/jac/41.4.494

Cited by 92 publications

(62 citation statements)

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“…Given the avail- (Table 8). In particular, colistin in combination with a carbapenem and/or rifampin appears most promising (194,239,351,373,415,518,537,541,613). Understandably, in the presence of significant carbapenemase activity, as opposed to membrane-based changes (porins and efflux pumps) that are likely disrupted by the polymyxins, synergy with carbapenems may be lost (592).…”

Section: Existing Antimicrobial Agentsmentioning

confidence: 99%

Acinetobacter baumannii : Emergence of a Successful Pathogen

2008

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SUMMARY Acinetobacter baumannii has emerged as a highly troublesome pathogen for many institutions globally. As a consequence of its immense ability to acquire or upregulate antibiotic drug resistance determinants, it has justifiably been propelled to the forefront of scientific attention. Apart from its predilection for the seriously ill within intensive care units, A. baumannii has more recently caused a range of infectious syndromes in military personnel injured in the Iraq and Afghanistan conflicts. This review details the significant advances that have been made in our understanding of this remarkable organism over the last 10 years, including current taxonomy and species identification, issues with susceptibility testing, mechanisms of antibiotic resistance, global epidemiology, clinical impact of infection, host-pathogen interactions, and infection control and therapeutic considerations.

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Section: Existing Antimicrobial Agentsmentioning

confidence: 99%

Acinetobacter baumannii : Emergence of a Successful Pathogen

2008

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“…The in vitro activities of polymyxins combined with other agents against A. baumannii (16,26,74,104,113,172,174), P. aeruginosa (26,93,165,171,174), K. pneumoniae (26), and Serratia marcescens (134, 173, 177) have been studied by the checkerboard methodology (Table 4). Against A. baumannii, the combination of polymyxin B or colistin with rifampin or azithromycin produced the synergistic inhibition (generally defined as a fractional inhibitory concentration index of Յ0.5) of most isolates.…”

Section: Bactericidal Activity and Synergy Studiesmentioning

confidence: 99%

Polymyxins Revisited

et al. 2008

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SUMMARY The global emergence of multidrug-resistant gram-negative bacilli has spurred a renewed interest in polymyxins. Once discarded due to concerns regarding nephrotoxicity and neurotoxicity, polymyxins now hold an important role in the antibiotic armamentarium. However, more reliable information is needed to determine the optimal dosing of these agents. Also, unanswered questions regarding in vitro testing remain, including questions regarding the reliability of automated systems and the establishment of appropriate breakpoints for defining susceptibility. Most contemporary clinical studies examining the use of these agents have involved patients with infections due to multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii strains. It has been reassuring that polymyxin therapy for resistant bacteria has resulted in clinical responses and toxicity rates similar to those for carbapenem therapy for susceptible isolates. While most surveillance studies demonstrated high rates of susceptibility, several reports noted the emergence of polymyxin-resistant nosocomial pathogens. Polymyxins have assumed an important antibiotic niche for therapy for hospital-acquired infections; further studies defining the optimal use of these agents will likely extend the duration of their clinical usefulness.

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“…is unknown, and there are limited reports assessing in vivo efficacy of antibiotics in either CF or non-CF patients. The optimal methodology for susceptibility testing of colistin is under investigation (9,14), as is the concentration deliverable by aerosolization (30).…”

Section: Most (89%) Isolates From Cf Patients Identified Asmentioning

confidence: 99%

Identification and Antimicrobial Susceptibility of Alcaligenes xylosoxidans Isolated from Patients with Cystic Fibrosis

et al. 2001

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In the past decade, potential pathogens, including Alcaligenes species, have been increasingly recovered from cystic fibrosis (CF) patients. Accurate identification of multiply antibiotic-resistant gram-negative bacilli is critical to understanding the epidemiology and clinical implications of emerging pathogens in CF. We examined the frequency of correct identification of Alcaligenes spp. by microbiology laboratories affiliated with American CF patient care centers. Selective media, an exotoxin A probe for Pseudomonas aeruginosa, and a commercial identification assay, API 20 NE, were used for identification. The activity of antimicrobial agents against these clinical isolates was determined. A total of 106 strains from 78 patients from 49 CF centers in 22 states were studied. Most (89%) were correctly identified by the referring laboratories as Alcaligenes xylosoxidans. However, 12 (11%) strains were misidentified; these were found to be P. aeruginosa (n ‫؍‬ 10), Stenotrophomonas maltophilia (n ‫؍‬ 1), and Burkholderia cepacia (n ‫؍‬ 1). Minocycline, imipenem, meropenem, piperacillin, and piperacillin-tazobactam were the most active since 51, 59, 51, 50, and 55% of strains, respectively, were inhibited. High concentrations of colistin (100 and 200 g/ml) inhibited 92% of strains. Chloramphenicol paired with minocycline and ciprofloxacin paired with either imipenem or meropenem were the most active combinations and inhibited 40 and 32%, respectively, of strains. Selective media and biochemical identification proved to be useful strategies for distinguishing A. xylosoxidans from other CF pathogens. Standards for processing CF specimens should be developed, and the optimal method for antimicrobial susceptibility testing of A. xylosoxidans should be determined.Cystic fibrosis (CF) is the most common life-shortening disease caused by a recessive autosomal gene in the Caucasian population and afflicts about 60,000 patients worldwide, approximately 30,000 of whom are cared for in the United States (21). While the genetic defect in CF is known, the relationship between abnormal CF transmembrane conductance regulator and chronic pulmonary disease is not yet fully understood (22). Chronic pulmonary disease is characterized by a vicious cycle of inflammation and infection and is the major cause of morbidity and mortality. The pathogens of CF are well characterized and include Staphylococcus aureus, nontypeable Haemophilus influenzae, Pseudomonas aeruginosa, and Burkholderia cepacia (10).During the past decade, several additional potential pathogens have been recovered from CF patients, including nontuberculous mycobacteria (19), Stenotrophomonas maltophilia (3), and Alcaligenes species, particularly Alcaligenes xylosoxidans (29). As reported to the U.S. Cystic Fibrosis Foundation's National Patient Registry in 1996 and 1997, 1.9 and 2.7% of all CF patients harbored Alcaligenes spp. (7,8). As determined by a research laboratory participating in a phase III trial of aerosolized tobramycin in CF patients who were Ն6 years of ...

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In-vitro activity of the combination of colistin and rifampicin against multidrug-resistant strains of Acinetobacter baumannii [published erratum appears in J Antimicrob Chemother 1998 Sep;42(3):413]

Cited by 92 publications

References 0 publications

Acinetobacter baumannii : Emergence of a Successful Pathogen

Acinetobacter baumannii : Emergence of a Successful Pathogen

Polymyxins Revisited

Identification and Antimicrobial Susceptibility of Alcaligenes xylosoxidans Isolated from Patients with Cystic Fibrosis

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