Department of Infectious Diseases, Marmara University School of Medicine, Istanbul, Turkey.
Department of Medical Microbiology, Marmara University School of Medicine, Istanbul, Turkey.
J Chemother. 2020 Sep;32(5):237-243. doi: 10.1080/1120009X.2020.1745501. Epub 2020 Mar 31.
Carbapenemase-producing (CPKp) infections are increasing worldwide. We investigated the in vitro synergistic activity of fosfomycin (FOS) with meropenem (MRP), amikacin (AMK) and colistin (COL) against OXA-48 and/or New Delhi metallo-beta-lactamase (NDM)-producing Kp blood isolates. Seventeen CPKp blood isolates were studied. The broth microdilution method was used for COL, MRP and AMK susceptibilities, while agar dilution for FOS. Synergy was tested by agar dilution chequerboard technique and also was confirmed by a time-kill assay for FOS/MRP and FOS/COL using three representative isolates that were found to be synergistic. FOS in combination with MRP was found to be the most synergistic (15/17 strains, 88%), while 29% and 41% with AMK and COL, respectively. Antagonism was only determined in 2 isolates with the COL/FOS. The MRP/FOS combination demonstrated synergistic activity against CRKp, especially against the two common enzyme-producing isolates in Turkey (OXA-48 and NDM).
产碳青霉烯酶（CPKp）感染在全球范围内不断增加。我们研究了磷霉素（FOS）与美罗培南（MRP）、阿米卡星（AMK）和多黏菌素（COL）联合应用对产 OXA-48 和/或新德里金属β-内酰胺酶（NDM）的 Kp 血源分离株的体外协同活性。研究了 17 株产 CPKp 的血源分离株。采用肉汤微量稀释法测定 COL、MRP 和 AMK 的药敏性，而采用琼脂稀释法测定 FOS 的药敏性。通过琼脂稀释棋盘试验检测协同作用，并通过时间杀伤试验对 FOS/MRP 和 FOS/COL 进行验证，使用三种被发现具有协同作用的代表性分离株。结果发现，FOS 与 MRP 联合应用最具协同作用（17 株中的 15 株，88%），而与 AMK 和 COL 联合应用的协同率分别为 29%和 41%。仅在 2 株分离株中观察到 COL/FOS 存在拮抗作用。MRP/FOS 联合应用对 CRKp 具有协同作用，尤其是对土耳其常见的两种产酶分离株（OXA-48 和 NDM）。
