Müderris Tuba, Dursun Manyaslı Gülden, Kaya Selçuk, Gül Yurtsever Süreyya
İzmir Katip Çelebi University, Faculty of Medicine, Department of Medical Microbiology, İzmir, Türkiye.
Ministry of Health Cizre Dr Selahattin Cizrelioglu State Hospital, Department of Medical Microbiology, Şırnak, Türkiye.
Diagn Microbiol Infect Dis. 2024 Oct;110(2):116408. doi: 10.1016/j.diagmicrobio.2024.116408. Epub 2024 Jun 20.
In this study, it was aimed to reveal the in vitro interactions of combinations of colistin with meropenem, rifampicin and tigecycline in colistin-resistant, biofilm-forming Klebsiella pneumonia. A total of 30 isolates, 15 of which formed biofilms and 15 did not form biofilms, were randomly selected from K. pneumoniae isolates growing in blood samples. The synergy rates of colistin-meropenem, colistin-tigecycline, colistin-rifampicin combinations in planktonic/sessile bacteria are; It was determined as 83,3%/73,3%, 66,6%/33,3%, 100%/60% respectively. Biofilm inhibitory concentration (BIC) of colistin, meropenem, tigecycline, and rifampicin significantly increased after biofilm formation. The synergistic activity seen in the sessile form was independent of the planktonic form. Although a high synergistic effect was observed in the meropenem-colistin combination on sessile bacteria, colistin had very high BIC in all combinations. Large-scale studies are needed in which the number of isolates studied is large, bacterial resistance profiles are evaluated genomically, and various antimicrobial groups are included.
在本研究中,旨在揭示在耐黏菌素、形成生物膜的肺炎克雷伯菌中,黏菌素与美罗培南、利福平及替加环素联合使用的体外相互作用。从血液样本中生长的肺炎克雷伯菌分离株中随机选取30株,其中15株形成生物膜,15株不形成生物膜。黏菌素-美罗培南、黏菌素-替加环素、黏菌素-利福平联合用药在浮游菌/固着菌中的协同率分别为83.3%/73.3%、66.6%/33.3%、100%/60%。生物膜形成后,黏菌素、美罗培南、替加环素和利福平的生物膜抑制浓度(BIC)显著增加。在固着菌形式中观察到的协同活性与浮游菌形式无关。尽管美罗培南-黏菌素联合用药对固着菌有很高的协同作用,但在所有联合用药中黏菌素的BIC都非常高。需要开展大规模研究,研究的分离株数量要多,从基因组层面评估细菌耐药谱,并纳入各种抗菌药物类别。