Department of Clinical Microbiology and Infectious Diseases, Gazi University School of Medicine Besevler, Ankara, Turkey.
J Antibiot (Tokyo). 2010 Feb;63(2):51-3. doi: 10.1038/ja.2009.117. Epub 2009 Nov 27.
The emergence of extensive drug-resistant (XDR) Acinetobacter baumannii limits the therapeutic options and leads to high mortality in intensive care units. Combined antibiotic therapy is frequently recommended for the treatment of these infections. Colistin (CO) and tigecycline (TIG), alone or in combination with other antimicrobials, are the most commonly used antibiotics in the treatment of these resistant infections. In this study, the in vitro synergistic activity of TIG and CO were tested for 25 XDR-A. baumannii strains isolated from ventilator-associated pneumonia by the Etest method. Resistance to CO was not detected, whereas 8% of the strains were resistant to TIG. The TIG-CO combination was more synergistic than TIG-rifampin and CO-rifampin according to the fractional inhibitory concentration index. No antagonism was detected between the drugs in the study. There was no strong correlation between the activity of the combinations with reference to strains or genotypes. Our results suggest that the combined use of TIG and CO may be useful for the treatment of XDR-A. baumannii infections.
广泛耐药(XDR)鲍曼不动杆菌的出现限制了治疗选择,并导致重症监护病房的高死亡率。联合抗生素治疗常被推荐用于治疗这些感染。多粘菌素(CO)和替加环素(TIG)单独或与其他抗菌药物联合使用,是治疗这些耐药感染最常用的抗生素。在这项研究中,通过 Etest 法检测了替加环素和多粘菌素对 25 株呼吸机相关性肺炎分离的 XDR-A.baumannii 菌株的体外协同活性。未检测到对 CO 的耐药性,而 8%的菌株对 TIG 耐药。根据部分抑菌浓度指数,TIG-CO 联合比 TIG-利福平和 CO-利福平更具协同作用。在研究中,两种药物之间没有检测到拮抗作用。组合的活性与菌株或基因型之间没有很强的相关性。我们的结果表明,替加环素和多粘菌素的联合使用可能对治疗 XDR-A.baumannii 感染有用。