Meng Qianlin, Lin Fei, Ling Baodong
Sichuan Province College Key Laboratory of Structure-Specific Small Molecule Drugs, Chengdu Medical College, Chengdu, China.
School of Pharmacy, Chengdu Medical College, Chengdu, China.
Front Pharmacol. 2022 May 11;13:890955. doi: 10.3389/fphar.2022.890955. eCollection 2022.
is one of the most dangerous opportunistic pathogens in the global health care setup. Its drug resistance and biofilm-forming capability are often associated with chronic infections that are difficult to treat. Therefore, the clinical treatments for highly drug-resistant are limited. Antimicrobial peptides are broad-spectrum antibacterial agents combined with antibiotics that minimize selective bacterial resistance and enhance antibacterial efficacy. The current study evaluated the synergistic antibacterial activities of clinically important peptide antibiotics combined with other antimicrobials against nine extensively drug-resistant strains in planktonic and biofilm cells . Polymyxin B and E combined with imipenem showed 100% synergy in the planktonic cell with the checkerboard. Moreover, polymyxin E with rifampicin and bacitracin with imipenem or meropenem showed 100% additive effects. In the biofilm cell, polymyxin B and E combined with azithromycin showed 100% synergy, when vancomycin with azithromycin, rifampicin, and bacitracin with azithromycin or rifampicin, and teicoplanin with tigecycline or rifampicin, all showed 100% additive effects. Therefore, peptide antibiotics combined with other antimicrobials have synergistic or additive effects on extensively drug-resistant in planktonic and biofilm cells. In addition, the combination of polymyxins with carbapenems or azithromycin could be an ideal therapy against extensively drug-resistant infections.
是全球医疗体系中最危险的机会性病原体之一。其耐药性和生物膜形成能力常与难以治疗的慢性感染相关。因此，针对高度耐药菌的临床治疗方法有限。抗菌肽是与抗生素联合使用的广谱抗菌剂，可将细菌的选择性耐药性降至最低并增强抗菌效果。本研究评估了临床上重要的肽类抗生素与其他抗菌剂联合对9株浮游菌和生物膜菌中的广泛耐药菌的协同抗菌活性。多粘菌素B和E与亚胺培南联合在浮游菌中棋盘法显示100%协同作用。此外，多粘菌素E与利福平以及杆菌肽与亚胺培南或美罗培南显示100%相加作用。在生物膜菌中，多粘菌素B和E与阿奇霉素联合显示100%协同作用，而万古霉素与阿奇霉素、利福平，杆菌肽与阿奇霉素或利福平，替考拉宁与替加环素或利福平，均显示100%相加作用。因此，肽类抗生素与其他抗菌剂联合对浮游菌和生物膜菌中的广泛耐药菌具有协同或相加作用。此外，多粘菌素与碳青霉烯类或阿奇霉素联合可能是治疗广泛耐药菌感染的理想疗法。
