Synergistic antibiotic combinations for colistin-resistant Klebsiella pneumoniae

Acta Microbiol Immunol Hung. 2013 Jun;60(2):201-9. doi: 10.1556/AMicr.60.2013.2.10.

Abstract

In this study antibiotic combinations for multidrug-resistant Klebsiella pneumoniae strains were investigated. The study included a colistin-susceptible and a colistin-resistant KPC-2 producing K. pneumoniae ST258 strains isolated in 2008 and 2009 during an outbreak in Hungary. Antibiotic combinations were analyzed by checkerboard technique and fractional inhibitory concentration indices were calculated. The following antibiotics were tested: ceftazidime, cefotaxime, ceftriaxone, ampicillin, imipenem, ertapenem, amikacin, tobramycin, ciprofloxacin, levofloxacin, moxifloxacin, rifampicin, polymyxin B and colistin. Combinations including 0.25 μg/ml colistin plus 1 μg/ml rifampicin, 0.25 μg/ml polymyxin B plus 1 μg/ml rifampicin, 1 μg/ml imipenem plus 2 μg/ml tobramycin, were found synergistic.These in vitro synergistic combinations suggest potential therapeutical options against infections caused by KPC-2 producing, multidrug-resistant K. pneumoniae ST258.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Ceftazidime / pharmacology
  • Colistin / pharmacology*
  • Drug Resistance, Bacterial*
  • Drug Synergism
  • Humans
  • Imipenem / pharmacology
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / drug effects*
  • Klebsiella pneumoniae / isolation & purification
  • Microbial Sensitivity Tests
  • Tobramycin / pharmacology

Substances

  • Anti-Bacterial Agents
  • Imipenem
  • Ceftazidime
  • Tobramycin
  • Colistin