In vitro synergy test of meropenem and sulbactam against clinical isolates of Acinetobacter baumannii

Kiffer, Carlos Roberto Veiga; Sampaio, Jorge Luiz Mello; Sinto, Sumiko I.; Oplustil, Carmen Paz; Koga, Paula Célia Mariko; Arruda, Andrea; Turner, Philip J.; Mendes, Caio

doi:10.1016/j.diagmicrobio.2005.03.003

Cited by 63 publications

(43 citation statements)

References 24 publications

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“…Much of the data comes from in vitro studies using checkerboard or time-kill analyses and shows enhanced activity when sulbactam is combined with cefepime (472,548), imipenem (86,518), meropenem (289,294), amikacin (481), rifampin (11), and ticarcillin-clavulanate (272). In a mouse pneumonia model, the combination of ticarcillin-clavulanate, sulbactam, and rifampin appeared most efficacious toward a carbapenemand sulbactam-resistant A. baumannii strain (rifampin MIC of 4 mg/liter); however, such effects were lost when a strain that was less susceptible to rifampin (MIC, 8 mg/liter) was tested (602).…”

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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“…Further studies concerning the combination of meropenem and ciprofloxacin revealed a small synergistic effect against the A. baumannii intensive care unit strains [52]. The research of Kiffer and co-workers showed that the combinations of meropenem and sulbactam may show synergism or partial synergism for analysed MDR A. baumannii isolates [53]. In the recent study, a combination of meropenem with minocycline was synergistic to tested XDR (extensively drug-resistant) A. baumannii isolates, but neither showed bactericidal activity alone.…”

Section: Clinical Usementioning

confidence: 99%

Acinetobacter baumannii: biology and drug resistance — role of carbapenemases

Nowak

Paluchowska

2015

Folia Histochem Cytobiol.

107

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Acinetobacter baumannii is a Gram-negative, glucose-non-fermenting, oxidase-negative coccobacillus, most commonly associated with the hospital settings. The ability to survive in adverse environmental conditions as well as high level of natural and acquired antimicrobial resistance make A. baumannii one of the most important nosocomial pathogens. While carbapenems have long been considered as antimicrobials of last-resort, the rates of clinical A. baumannii strains resistant to these antibiotics are increasing worldwide. Carbapenem resistance among A. baumannii is conferred by coexisting mechanisms including: decrease in permeability of the outer membrane, efflux pumps, production of beta-lactamases, and modification of penicillin-binding proteins. The most prevalent mechanism of carbapenem resistance among A. baumannii is associated with carbapenem-hydrolysing enzymes that belong to Ambler class D and B beta-lactamases. In addition, there have also been reports of resistance mediated by selected Ambler class A carbapenemases among A. baumannii strains. Resistance determinants in A. baumannii are located on chromosome and plasmids, while acquisition of new mechanisms can be mediated by insertion sequences, integrons, transposons, and plasmids. Clinical relevance of carbapenem resistance among strains isolated from infected patients, carriers and hospital environment underlines the need for carbapenemase screening. Currently available methods vary in principle, accuracy and efficiency. The techniques that deserve particular attention belong to both easily accessible unsophisticated methods as well as advanced techniques based on mass spectrometry or molecular biology. While carbapenemases limit the therapeutic options in A. baumannii infections, studies concerning novel beta-lactamase inhibitors offer a new insight into effective therapy.

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“…The fractional inhibitory concentration index (FICI) was obtained by the sum of the FICs of each drug. The FICI was interpreted as follows: FICI 0.5 represented synergy, 0.5 < FICI < 1 represented partial synergy, FICI = 1 represented additive effects, 1 < FICI < 4 represented indifference, and FICI 4 represented antagonism 14,15 .…”

Section: Antimicrobial Combination Testingmentioning

confidence: 99%

Antimicrobial susceptibility of Acinetobacter baumannii isolated from hospital patients

Tunyapanit¹,

Pruekprasert²,

Laoprasopwattana³

et al. 2014

ScienceAsia

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ABSTRACT:The incidence of multidrug-resistant Acinetobacter baumannii (MDR A. baumannii) is increasing worldwide and is leading to therapeutic problems. We investigated the in vitro activities of cefoperazone/sulbactam, colistin, imipenem, and rifampicin alone and in double combinations against 100 A. baumannii isolates from patients at Songklanagarind Hospital in Songkhla Province, Thailand. The E-test method was used to determine antimicrobial susceptibility, the minimal inhibitory concentration (MIC) and for antimicrobial combination testing. A. baumannii isolates were susceptible to colistin (97%), cefoperazone/sulbactam (69%), imipenem (45%), and rifampicin (13%). Fifty-nine percent of them were MDR A. baumannii. Colistin was superior to cefoperazone/sulbactam, rifampicin and imipenem against MDR A. baumannii and the MIC50, MIC90 of colistin were 0.75 and 1 µg/ml, respectively. Non-MDR A. baumannii isolates were susceptible to cefoperazone/sulbactam (100%), colistin (95%), imipenem (93%) and rifampicin (2%). Combinations of cefoperazone/sulbactam plus colistin or rifampicin, imipenem plus colistin or rifampicin and colistin plus rifampicin showed indifferent effects against most MDR isolates. Of all the antimicrobial combinations tested, cefoperazone/sulbactam plus rifampicin produced the highest percentages (42%) of synergy, partial synergy, and additive results. The activity rate of cefoperazone/sulbactam against MDR A. baumannii was higher when combined with rifampicin than colistin. Thus colistin had the greatest activity against most MDR and non-MDR A. baumannii isolates among all of the antibiotics tested. Cefoperazone/sulbactam and imipenem showed good activity against non-MDR isolates, and cefoperazone/sulbactam combined with rifampicin may be useful in treating infections caused by MDR isolates.

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In vitro synergy test of meropenem and sulbactam against clinical isolates of Acinetobacter baumannii

Cited by 63 publications

References 24 publications

Acinetobacter baumannii : Emergence of a Successful Pathogen

Acinetobacter baumannii : Emergence of a Successful Pathogen

Acinetobacter baumannii: biology and drug resistance — role of carbapenemases

Antimicrobial susceptibility of Acinetobacter baumannii isolated from hospital patients

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