Kaya Ilkem Acar, Guner Muberra Devrim, Akca Gulcin, Tuncbilek Semra, Alhan Aslihan, Tekeli Emin
Ilkem Acar Kaya, MD. Infectious Diseases and Clinical Microbiology Department, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Muberra Devrim Guner, Associate Professor, TOBB Economics and Technology University, Medical School Medical Pharmacology Department, Ankara, Turkey.
Pak J Med Sci. 2017 Mar-Apr;33(2):393-397. doi: 10.12669/pjms.332.11933.
species cause nosocomial infections and can subsequently develop multidrug resistance (MDR). The objective of this study was to evaluate the susceptibility of A. baumannii to a novel combination of colistin and tigecycline, which may provide a faster and more efficacious treatment via a synergistic effect.
We included 50 MDR samples that were isolated in our clinics between 2009 and 2014. We used broth microdilution (BMD) and the E-test to evaluate the effects of colistin and tigecycline, and the E-test to assess the interaction of the colistin-tigecycline combination. The interaction between the two antibiotics was evaluated using the fractional inhibition concentration (FIC) index and was classified as follows: FIC≤0.5, synergistic; 0.5<FIC<1, partially synergistic; FIC=1, additive; 1<FIC<4, indifferent; and FIC≥4, antagonistic.
No tigecycline and colistin resistance was determined by BMD or E-test. The interaction between colistin and tigecycline, when used in combination, was 2% synergistic, 6% additive, 88% indifferent, and 4% antagonistic.
Although combination therapy is suggested for MDR infections, our results suggest that the synergistic effect of the colistin-tigecycline combination is insufficient to make it an optimal treatment choice.
某些菌种可引发医院感染并随后产生多重耐药性（MDR）。本研究的目的是评估鲍曼不动杆菌对黏菌素和替加环素新组合的敏感性，该组合可能通过协同作用提供更快且更有效的治疗。
我们纳入了2009年至2014年间在我们诊所分离出的50份多重耐药样本。我们使用肉汤微量稀释法（BMD）和E-test来评估黏菌素和替加环素的效果，并使用E-test评估黏菌素 - 替加环素组合的相互作用。使用分数抑菌浓度（FIC）指数评估两种抗生素之间的相互作用，分类如下：FIC≤0.5，协同作用；0.5＜FIC＜1，部分协同作用；FIC = 1，相加作用；1＜FIC＜4，无关作用；FIC≥4，拮抗作用。
通过BMD或E-test未检测到对替加环素和黏菌素的耐药性。黏菌素和替加环素联合使用时，其相互作用为2%协同、6%相加、88%无关和4%拮抗。
尽管建议对多重耐药感染进行联合治疗，但我们的结果表明黏菌素 - 替加环素组合的协同作用不足以使其成为最佳治疗选择。
