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索利霉素与其他抗菌药物联合用于对抗耐碳青霉烯类肺炎克雷伯菌(CRKP)。

Solithromycin in Combination with Other Antimicrobial Agents Against the Carbapenem Resistant (CRKP).

作者信息

Rani Kusum, Tripathi Shyam, Sharma Amit, Sharma Shingini, Sheba Poornima, Samuel Raj V

机构信息

Department of Biotechnology, SRM University, Delhi-NCR, Rajiv Gandhi Education City, Sonipat, Haryana 131029 India.

出版信息

Indian J Microbiol. 2024 Jun;64(2):540-547. doi: 10.1007/s12088-024-01188-8. Epub 2024 Apr 18.

Abstract

is considered as the most common pathogen of hospital-acquired pneumonia. has emerged as the superbug which had shown multidrug resistance (MDR) as well as extensively drug resistance. Carbapenem resistant (CRKP) has become a menace for the treatment with monotherapy of the patients mainly admitted in intensive care units. Hence, in the present study we collected total 187 sputum isolates of and performed the antimicrobial susceptibility testing by using the automated Vitek-2 system and broth micro-dilution method (67 CRKP). The combination study of solithromycin with meropenem, colistin, cefotaxime, piperacillin and tazobactam, nitrofurantoin, tetracycline, levofloxacin, curcumin and nalidixic acid was performed by using checkerboard assay. We observed the high rate of resistance towards ampicillin, cefotaxime, ceftriaxone, cefuroxime and aztreonam. The colistin and tigecycline were the most sensitive drugs. The CRKP were 36%, maximum were from the patients of ICUs. The best synergistic effect of solithromycin was with meropenem and cefotaxime (100%), colistin and tetracycline (80%). So, these combinations can be a choice of treatment for the infections caused by MDR CRKP and other Gram-negative bacteria where the monotherapy could not work.

摘要

被认为是医院获得性肺炎最常见的病原体。已成为显示多重耐药(MDR)以及广泛耐药的超级细菌。耐碳青霉烯类 (CRKP) 已成为主要入住重症监护病房患者单一疗法治疗的一大威胁。因此,在本研究中,我们总共收集了187株 的痰液分离株,并使用自动Vitek-2系统和肉汤微量稀释法进行了药敏试验(67株CRKP)。通过棋盘法进行了索利霉素与美罗培南、黏菌素、头孢噻肟、哌拉西林和他唑巴坦、呋喃妥因、四环素、左氧氟沙星、姜黄素和萘啶酸的联合研究。我们观察到对氨苄西林、头孢噻肟、头孢曲松、头孢呋辛和氨曲南的耐药率很高。黏菌素和替加环素是最敏感的药物。CRKP占36%,最多来自重症监护病房的患者。索利霉素与美罗培南和头孢噻肟(100%)、黏菌素和四环素(80%)的协同作用最佳。因此,对于由MDR CRKP和其他革兰氏阴性菌引起的感染,单一疗法无效时,这些联合用药可作为治疗选择。

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