In vitro analysis of colistin-carbapenem combination activity against Acinetobacter spp infection
Introduction: Increasing carbapenem resistance in Acinetobacter spp calls for the appraisal of alternative strategies in Acinetobacter spp infection therapy. This study aims at evaluating colistin-carbapenem combination against Acinetobacter spp using the checkerboard, Etest, and time-kill methods....
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The Journal of Infection in Developing Countries
2018-02-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/10072 |
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| author | Micheline Soudeiha E Salem Sokhn Ziad Daoud Dolla Sarkis |
| author_facet | Micheline Soudeiha E Salem Sokhn Ziad Daoud Dolla Sarkis |
| author_sort | Micheline Soudeiha |
| collection | DOAJ |
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Introduction: Increasing carbapenem resistance in Acinetobacter spp calls for the appraisal of alternative strategies in Acinetobacter spp infection therapy. This study aims at evaluating colistin-carbapenem combination against Acinetobacter spp using the checkerboard, Etest, and time-kill methods.
Methodology: One hundred nonrepetitive Acinetobacter spp isolates were collected from patients admitted at the Saint-George-Hospital-University-Medical-Center over a one year period. The identification was performed using the API20NE and confirmed by the amplification of the blaOXA-51-like. Susceptibility to colistin, and carbapenems were determined using the Etest, microdilution methods and interpreted according to the CLSI, 2015. Detection of the carbapenemases was performed by PCR amplification method. Clonality was determined by the 3-Locus PCR-typing and ERIC-PCR methods. The synergistic potential of the combination was determined by calculating the Fractional-Inhibitory-Concentration-Index, which determines a synergistic, additive, indifferent or antagonistic effect.
Results: In our study (84%) of the isolates were carbapenem resistant. Only one strain showed resistance to colistin. (99%) and (77%) of the Acinetobacter spp isolates harbored blaOXA-51-like and blaOXA-23-like respectively. (86.2%) of the A.baumannii isolates pertained to the International Clone II. An additive effect of the colistin-carbapenem combination was determined using the 3 methods. A decrease of 2.6 and 2.8 folds in the MIC of colistin was showed in colistin-meropenem and colistin-imipenem, respectively (p < 0.001). The Colistin-meropenem showed better effects when compared to colistin-imipenem (p < 0.05). Only a few isolates showed a synergistic effect in the time-kill assay.
Conclusion: Our study showed that the decrease in the MIC of colistin following colistin-carbapenem combination might be a promising antimicrobial approach for treating carbapenem-resistant Acinetobacter spp.
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| format | Article |
| id | doaj-art-626a7ae53c79460bae7cda83d828dcc3 |
| institution | Kabale University |
| issn | 1972-2680 |
| language | English |
| publishDate | 2018-02-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-626a7ae53c79460bae7cda83d828dcc32025-08-20T03:52:43ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802018-02-011202.110.3855/jidc.10072In vitro analysis of colistin-carbapenem combination activity against Acinetobacter spp infectionMicheline Soudeiha0E Salem Sokhn1Ziad Daoud2Dolla Sarkis3Rodolphe Merieux Laboratory, School of Pharmacy, Saint Joseph University, Beirut, LebanonBiomedical sciences department, Faculty of Medicine and Medical Sciences, University of Balamand, Koura, LebanonBiomedical sciences department, Faculty of Medicine and Medical Sciences, University of Balamand, Koura, LebanonRodolphe Merieux Laboratory, School of Pharmacy, Saint Joseph University, Beirut, Lebanon Introduction: Increasing carbapenem resistance in Acinetobacter spp calls for the appraisal of alternative strategies in Acinetobacter spp infection therapy. This study aims at evaluating colistin-carbapenem combination against Acinetobacter spp using the checkerboard, Etest, and time-kill methods. Methodology: One hundred nonrepetitive Acinetobacter spp isolates were collected from patients admitted at the Saint-George-Hospital-University-Medical-Center over a one year period. The identification was performed using the API20NE and confirmed by the amplification of the blaOXA-51-like. Susceptibility to colistin, and carbapenems were determined using the Etest, microdilution methods and interpreted according to the CLSI, 2015. Detection of the carbapenemases was performed by PCR amplification method. Clonality was determined by the 3-Locus PCR-typing and ERIC-PCR methods. The synergistic potential of the combination was determined by calculating the Fractional-Inhibitory-Concentration-Index, which determines a synergistic, additive, indifferent or antagonistic effect. Results: In our study (84%) of the isolates were carbapenem resistant. Only one strain showed resistance to colistin. (99%) and (77%) of the Acinetobacter spp isolates harbored blaOXA-51-like and blaOXA-23-like respectively. (86.2%) of the A.baumannii isolates pertained to the International Clone II. An additive effect of the colistin-carbapenem combination was determined using the 3 methods. A decrease of 2.6 and 2.8 folds in the MIC of colistin was showed in colistin-meropenem and colistin-imipenem, respectively (p < 0.001). The Colistin-meropenem showed better effects when compared to colistin-imipenem (p < 0.05). Only a few isolates showed a synergistic effect in the time-kill assay. Conclusion: Our study showed that the decrease in the MIC of colistin following colistin-carbapenem combination might be a promising antimicrobial approach for treating carbapenem-resistant Acinetobacter spp. https://jidc.org/index.php/journal/article/view/10072Acinetobacter sppadditive combinationICII |
| spellingShingle | Micheline Soudeiha E Salem Sokhn Ziad Daoud Dolla Sarkis In vitro analysis of colistin-carbapenem combination activity against Acinetobacter spp infection Journal of Infection in Developing Countries Acinetobacter spp additive combination ICII |
| title | In vitro analysis of colistin-carbapenem combination activity against Acinetobacter spp infection |
| title_full | In vitro analysis of colistin-carbapenem combination activity against Acinetobacter spp infection |
| title_fullStr | In vitro analysis of colistin-carbapenem combination activity against Acinetobacter spp infection |
| title_full_unstemmed | In vitro analysis of colistin-carbapenem combination activity against Acinetobacter spp infection |
| title_short | In vitro analysis of colistin-carbapenem combination activity against Acinetobacter spp infection |
| title_sort | in vitro analysis of colistin carbapenem combination activity against acinetobacter spp infection |
| topic | Acinetobacter spp additive combination ICII |
| url | https://jidc.org/index.php/journal/article/view/10072 |
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