a Department of Infectious Diseases.
b Department of Dentistry , the First Affiliated Hospital of Anhui Medical University , Hefei , PR China.
Infect Dis (Lond). 2016;48(3):189-94. doi: 10.3109/23744235.2015.1103894. Epub 2015 Oct 26.
With increasing antibiotic resistance, the selection of effective treatment of A. baumannii infections is particularly challenging.
This study assessed the activities of the combination of vancomycin and colistin combination in vitro and in vivo using a Galleria mellonella model against four colistin-susceptible or colistin-resistant A. baumannii strains.
In checkerboard assays, synergy was observed between vancomycin and colistin for all four strains tested (0.156 ≤ Fractional inhibitory concentration indices [FICI] ≤ 0.281). In time-kill assays, the combination showed continued bactericidal activity and synergy after 24 h for colistin-susceptible strains. For colistin-resistant strains, the combination resulted in bactericidal activity within 8 h, but sustained bacterial re-growth was then observed. Treatment of G. mellonella larvae infected with lethal doses of A. baumannii (except 19606R) resulted in significantly increased survival rates when vancomycin was given with colistin compared to colistin treatment alone (p < 0.05).
These findings suggest that regimens containing vancomycin may be useful for infections due to multidrug-resistant Acinetobacter baumannii.
随着抗生素耐药性的增加，有效治疗鲍曼不动杆菌感染的选择特别具有挑战性。
本研究使用大蜡螟模型评估了万古霉素和黏菌素联合使用对 4 株对黏菌素敏感或耐药的鲍曼不动杆菌菌株的体外和体内活性。
在棋盘微量稀释法试验中，万古霉素和黏菌素对所有 4 株受试菌株均表现出协同作用（0.156≤分数抑菌浓度指数[FICI]≤0.281）。在时间杀伤试验中，对于黏菌素敏感株，联合用药在 24 小时后仍显示持续杀菌活性和协同作用。对于黏菌素耐药株，联合用药在 8 小时内产生杀菌活性，但随后观察到细菌持续生长。当万古霉素与黏菌素联合使用治疗致死剂量的鲍曼不动杆菌感染的大蜡螟幼虫时，与单独使用黏菌素相比，存活率显著提高（p<0.05）。
这些发现表明，含有万古霉素的方案可能对多药耐药鲍曼不动杆菌感染有用。
