Activity of the colistin-rifampicin combination against colistin-resistant, carbapenemase-producing Gram-negative bacteria

Colistin (COL) is one of the few antimicrobials that retain activity against carbapenemase-producing Gram-negative bacteria (GNB). However, the emergence of COL resistance has renewed the use of combination therapy. The aim of this study was to determine the activity of COL plus rifampicin (RIF) aga...

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Bibliographic Details
Published in:Journal of chemotherapy (Florence) 2014-08, Vol.26 (4), p.211-216
Main Authors: Nastro, Marcela, Rodríguez, Carlos Hernan, Monge, Renata, Zintgraff, Jonathan, Neira, Liliana, Rebollo, Mirta, Vay, Carlos, Famiglietti, Angela
Format: Article
Language:English
Subjects:
Acinetobacter baumannii
Acinetobacter baumannii - drug effects
Acinetobacter baumannii - enzymology
Acinetobacter baumannii - isolation & purification
Anti-Bacterial Agents - pharmacology
Antibiotics. Antiinfectious agents. Antiparasitic agents
Bacterial Proteins - metabolism
beta-Lactamases - metabolism
Biological and medical sciences
Carbapenemase
Colistin - pharmacology
Colistin resistance
Combination studies
Dose-Response Relationship, Drug
Drug Resistance, Bacterial - drug effects
Gram-negative bacteria
Gram-Negative Bacteria - drug effects
Gram-Negative Bacteria - enzymology
Gram-Negative Bacteria - isolation & purification
Humans
Klebsiella pneumoniae
Klebsiella pneumoniae - drug effects
Klebsiella pneumoniae - enzymology
Klebsiella pneumoniae - isolation & purification
Medical sciences
Microbial Sensitivity Tests
Pharmacology. Drug treatments
Rifampin - pharmacology
Serratia marcescens
Serratia marcescens - drug effects
Serratia marcescens - enzymology
Serratia marcescens - isolation & purification
Structure-Activity Relationship
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Summary:Colistin (COL) is one of the few antimicrobials that retain activity against carbapenemase-producing Gram-negative bacteria (GNB). However, the emergence of COL resistance has renewed the use of combination therapy. The aim of this study was to determine the activity of COL plus rifampicin (RIF) against clinical isolates of COL-resistant, carbapenemase-producing GNB. We employed 36 COL-resistant carbapenemase-producing isolates (27 Klebsiella pneumoniae, 5 Serratia marcescens, and 4 Acinetobacter baumannii) belonging to 36 patients. E-test/agar dilution of all strains was performed with E-test strips of COL placed on agar plates with and without RIF. In 11 patients, the synergy was confirmed by time-kill studies. Synergy was detected in 34 isolates, whereas indifference was detected in two S. marcescens. The E-test/agar dilution method showed comparable results to the time-kill studies. Seven patients infected with these isolates (two meningitis, four sepsis, and one urinary tract infection) were treated with the combination successfully.
ISSN:1120-009X
1973-9478
DOI:10.1179/1973947813Y.0000000136