In vitro activities of non-traditional antimicrobials alone or in combination against multidrug-resistant strains of Pseudomonas aeruginosa and Acinetobacter baumannii isolated from intensive care units

The aim of this study was to assess the in vitro activity of a number of non-traditional antibiotics (colistin, azithromycin, doxycycline and rifampicin) against multidrug-resistant (MDR) strains of Pseudomonas aeruginosa and Acinetobacter baumannii isolated from Intensive Care Units (ICUs). We also...

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Veröffentlicht in:International journal of antimicrobial agents 2006-03, Vol.27 (3), p.224-228
Hauptverfasser: Timurkaynak, Funda, Can, Fusun, Azap, Özlem Kurt, Demirbilek, Müge, Arslan, Hande, Karaman, Sedef Özbalıkçı
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container_issue 3
container_start_page 224
container_title International journal of antimicrobial agents
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creator Timurkaynak, Funda
Can, Fusun
Azap, Özlem Kurt
Demirbilek, Müge
Arslan, Hande
Karaman, Sedef Özbalıkçı
description The aim of this study was to assess the in vitro activity of a number of non-traditional antibiotics (colistin, azithromycin, doxycycline and rifampicin) against multidrug-resistant (MDR) strains of Pseudomonas aeruginosa and Acinetobacter baumannii isolated from Intensive Care Units (ICUs). We also used the checkerboard method to determine whether combinations of colistin with another non-traditional antibiotic or meropenem act synergistically against these strains. Thirty-five P. aeruginosa and 25 A. baumannii strains that were found to be MDR were included the study. Isolates were collected from the specimens of patients in ICUs from 2001 to 2003. All isolates were identified by standard methods and stored at −20 °C until use. Antibiotic powders of azithromycin, doxycycline, rifampicin, meropenem and colistin were obtained from their manufacturers. Minimum inhibitory concentrations (MICs) were determined by the agar dilution method on Mueller–Hinton agar. Five strains of A. baumannii and five strains of P. aeruginosa, all of which had different MIC values for colistin, were selected for the synergy study using the checkerboard titration method. The susceptibility results for doxycycline and meropenem were interpreted according to National Committee for Clinical Laboratory Standards guidelines. The susceptibility breakpoints for colistin and rifampicin were established as 4 mg/L and 2 mg/L, respectively, based on previous studies. Pseudomonas aeruginosa ATCC 27853 and Escherichia coli ATCC 25922 were used as control strains. Testing against the P. aeruginosa strains revealed high MIC 50 values for all the drugs except colistin. Doxycycline and colistin were both effective against the A. baumannii strains, with high susceptibility rates of 92% and 100%, respectively. Azithromycin had a high MIC 50 value against these strains, whilst rifampicin had a moderate effect (susceptibility rate 64%). The combination of colistin and rifampicin was fully synergistic against four A. baumannii and two P. aeruginosa strains. Combinations of colistin with meropenem and of colistin with azithromycin each showed synergistic activity against three A. baumannii isolates, whilst the same combinations resulted in generally additive or indifferent effects against P. aeruginosa strains. The colistin and doxycycline combination was generally partially synergistic or additive against all the isolates. MDR strains of P. aeruginosa and A. baumannii, which cause nosocomial infection
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We also used the checkerboard method to determine whether combinations of colistin with another non-traditional antibiotic or meropenem act synergistically against these strains. Thirty-five P. aeruginosa and 25 A. baumannii strains that were found to be MDR were included the study. Isolates were collected from the specimens of patients in ICUs from 2001 to 2003. All isolates were identified by standard methods and stored at −20 °C until use. Antibiotic powders of azithromycin, doxycycline, rifampicin, meropenem and colistin were obtained from their manufacturers. Minimum inhibitory concentrations (MICs) were determined by the agar dilution method on Mueller–Hinton agar. Five strains of A. baumannii and five strains of P. aeruginosa, all of which had different MIC values for colistin, were selected for the synergy study using the checkerboard titration method. The susceptibility results for doxycycline and meropenem were interpreted according to National Committee for Clinical Laboratory Standards guidelines. The susceptibility breakpoints for colistin and rifampicin were established as 4 mg/L and 2 mg/L, respectively, based on previous studies. Pseudomonas aeruginosa ATCC 27853 and Escherichia coli ATCC 25922 were used as control strains. Testing against the P. aeruginosa strains revealed high MIC 50 values for all the drugs except colistin. Doxycycline and colistin were both effective against the A. baumannii strains, with high susceptibility rates of 92% and 100%, respectively. Azithromycin had a high MIC 50 value against these strains, whilst rifampicin had a moderate effect (susceptibility rate 64%). The combination of colistin and rifampicin was fully synergistic against four A. baumannii and two P. aeruginosa strains. Combinations of colistin with meropenem and of colistin with azithromycin each showed synergistic activity against three A. baumannii isolates, whilst the same combinations resulted in generally additive or indifferent effects against P. aeruginosa strains. The colistin and doxycycline combination was generally partially synergistic or additive against all the isolates. MDR strains of P. aeruginosa and A. baumannii, which cause nosocomial infections with an increasing ratio in recent years, have limited treatment options. According to our in vitro study results, non-traditional antibiotics such as doxycycline and colistin can be an alternative for the treatment of infections caused by these strains. Combinations of colistin with non-traditional antibiotics or meropenem could be promising alternatives for the treatment of infections due to MDR strains of A. baumannii and P. aeruginosa.</description><identifier>ISSN: 0924-8579</identifier><identifier>EISSN: 1872-7913</identifier><identifier>DOI: 10.1016/j.ijantimicag.2005.10.012</identifier><identifier>PMID: 16464562</identifier><language>eng</language><publisher>London: Elsevier B.V</publisher><subject>Acinetobacter baumannii ; Acinetobacter baumannii - drug effects ; Acinetobacter baumannii - isolation &amp; purification ; Acinetobacter Infections - drug therapy ; Acinetobacter Infections - microbiology ; Anti-Bacterial Agents - pharmacology ; Anti-Bacterial Agents - therapeutic use ; Antibiotics. Antiinfectious agents. 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We also used the checkerboard method to determine whether combinations of colistin with another non-traditional antibiotic or meropenem act synergistically against these strains. Thirty-five P. aeruginosa and 25 A. baumannii strains that were found to be MDR were included the study. Isolates were collected from the specimens of patients in ICUs from 2001 to 2003. All isolates were identified by standard methods and stored at −20 °C until use. Antibiotic powders of azithromycin, doxycycline, rifampicin, meropenem and colistin were obtained from their manufacturers. Minimum inhibitory concentrations (MICs) were determined by the agar dilution method on Mueller–Hinton agar. Five strains of A. baumannii and five strains of P. aeruginosa, all of which had different MIC values for colistin, were selected for the synergy study using the checkerboard titration method. The susceptibility results for doxycycline and meropenem were interpreted according to National Committee for Clinical Laboratory Standards guidelines. The susceptibility breakpoints for colistin and rifampicin were established as 4 mg/L and 2 mg/L, respectively, based on previous studies. Pseudomonas aeruginosa ATCC 27853 and Escherichia coli ATCC 25922 were used as control strains. Testing against the P. aeruginosa strains revealed high MIC 50 values for all the drugs except colistin. Doxycycline and colistin were both effective against the A. baumannii strains, with high susceptibility rates of 92% and 100%, respectively. Azithromycin had a high MIC 50 value against these strains, whilst rifampicin had a moderate effect (susceptibility rate 64%). The combination of colistin and rifampicin was fully synergistic against four A. baumannii and two P. aeruginosa strains. Combinations of colistin with meropenem and of colistin with azithromycin each showed synergistic activity against three A. baumannii isolates, whilst the same combinations resulted in generally additive or indifferent effects against P. aeruginosa strains. The colistin and doxycycline combination was generally partially synergistic or additive against all the isolates. MDR strains of P. aeruginosa and A. baumannii, which cause nosocomial infections with an increasing ratio in recent years, have limited treatment options. According to our in vitro study results, non-traditional antibiotics such as doxycycline and colistin can be an alternative for the treatment of infections caused by these strains. Combinations of colistin with non-traditional antibiotics or meropenem could be promising alternatives for the treatment of infections due to MDR strains of A. baumannii and P. aeruginosa.</description><subject>Acinetobacter baumannii</subject><subject>Acinetobacter baumannii - drug effects</subject><subject>Acinetobacter baumannii - isolation &amp; purification</subject><subject>Acinetobacter Infections - drug therapy</subject><subject>Acinetobacter Infections - microbiology</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Biological and medical sciences</subject><subject>Colistin</subject><subject>Drug Resistance, Multiple, Bacterial</subject><subject>Drug Synergism</subject><subject>Drug Therapy, Combination</subject><subject>Escherichia coli</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Medical sciences</subject><subject>Microbial Sensitivity Tests</subject><subject>Multidrug-resistant</subject><subject>Non-traditional antimicrobials</subject><subject>Pharmacology. Drug treatments</subject><subject>Pseudomonas aeruginosa</subject><subject>Pseudomonas aeruginosa - drug effects</subject><subject>Pseudomonas aeruginosa - isolation &amp; purification</subject><subject>Pseudomonas Infections - drug therapy</subject><subject>Pseudomonas Infections - microbiology</subject><subject>Synergy</subject><issn>0924-8579</issn><issn>1872-7913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc-O0zAQxi0EYruFV0DmALcUO4mT9Liq-LPSSnCAczSxJ9VUib14nEq8Ik-Fo1ZajnuyNfOb7xvNJ8R7rXZa6ebTaUcn8IlmsnDclUqZXN8pXb4QG921ZdHudfVSbNS-rIvOtPsbcct8UkqbqjavxY1u6qY2TbkRf--9PFOKQYJNlH-ELMMoffBFiuByIXiY5NUuhoFgYglT8ChDlOSlDfNAHlZQwhHIc5LzMiVycTkWEZk45XHJWS83V_UfjIsLc1bOUpgx8oEhmzh5Z8ljCkNeB6McYJnBeyJJHCZI6OQYw5xtE3qmM0oLEeXiKfEb8WrMu-Hb67sVv758_nn4Vjx8_3p_uHsorCnbVIxQ26GqodRGuXFsTadN6To03djqyjXGmKYdFFrl2tE2la50XXbDAGjLPVhXbcXHi-5jDL8X5NTPxBanCTyGhXvd1p1pcgJbsb-A-WzMEcf-MdIM8U-vVb8G2Z_6_4Ls1yDXVg4yz767mizDjO5p8ppcBj5cAWAL0xjBW-InrjUZbKrMHS4c5pOcCWPPltBbdBTRpt4FesY6_wBgismp</recordid><startdate>20060301</startdate><enddate>20060301</enddate><creator>Timurkaynak, Funda</creator><creator>Can, Fusun</creator><creator>Azap, Özlem Kurt</creator><creator>Demirbilek, Müge</creator><creator>Arslan, Hande</creator><creator>Karaman, Sedef Özbalıkçı</creator><general>Elsevier B.V</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope></search><sort><creationdate>20060301</creationdate><title>In vitro activities of non-traditional antimicrobials alone or in combination against multidrug-resistant strains of Pseudomonas aeruginosa and Acinetobacter baumannii isolated from intensive care units</title><author>Timurkaynak, Funda ; Can, Fusun ; Azap, Özlem Kurt ; Demirbilek, Müge ; Arslan, Hande ; Karaman, Sedef Özbalıkçı</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c527t-fa4cb34a2150dff758152d8e58f713d655567b0ec0d7fc63131428bbaec29acd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Acinetobacter baumannii</topic><topic>Acinetobacter baumannii - drug effects</topic><topic>Acinetobacter baumannii - isolation &amp; purification</topic><topic>Acinetobacter Infections - drug therapy</topic><topic>Acinetobacter Infections - microbiology</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Biological and medical sciences</topic><topic>Colistin</topic><topic>Drug Resistance, Multiple, Bacterial</topic><topic>Drug Synergism</topic><topic>Drug Therapy, Combination</topic><topic>Escherichia coli</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Medical sciences</topic><topic>Microbial Sensitivity Tests</topic><topic>Multidrug-resistant</topic><topic>Non-traditional antimicrobials</topic><topic>Pharmacology. Drug treatments</topic><topic>Pseudomonas aeruginosa</topic><topic>Pseudomonas aeruginosa - drug effects</topic><topic>Pseudomonas aeruginosa - isolation &amp; purification</topic><topic>Pseudomonas Infections - drug therapy</topic><topic>Pseudomonas Infections - microbiology</topic><topic>Synergy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Timurkaynak, Funda</creatorcontrib><creatorcontrib>Can, Fusun</creatorcontrib><creatorcontrib>Azap, Özlem Kurt</creatorcontrib><creatorcontrib>Demirbilek, Müge</creatorcontrib><creatorcontrib>Arslan, Hande</creatorcontrib><creatorcontrib>Karaman, Sedef Özbalıkçı</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>International journal of antimicrobial agents</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Timurkaynak, Funda</au><au>Can, Fusun</au><au>Azap, Özlem Kurt</au><au>Demirbilek, Müge</au><au>Arslan, Hande</au><au>Karaman, Sedef Özbalıkçı</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>In vitro activities of non-traditional antimicrobials alone or in combination against multidrug-resistant strains of Pseudomonas aeruginosa and Acinetobacter baumannii isolated from intensive care units</atitle><jtitle>International journal of antimicrobial agents</jtitle><addtitle>Int J Antimicrob Agents</addtitle><date>2006-03-01</date><risdate>2006</risdate><volume>27</volume><issue>3</issue><spage>224</spage><epage>228</epage><pages>224-228</pages><issn>0924-8579</issn><eissn>1872-7913</eissn><abstract>The aim of this study was to assess the in vitro activity of a number of non-traditional antibiotics (colistin, azithromycin, doxycycline and rifampicin) against multidrug-resistant (MDR) strains of Pseudomonas aeruginosa and Acinetobacter baumannii isolated from Intensive Care Units (ICUs). We also used the checkerboard method to determine whether combinations of colistin with another non-traditional antibiotic or meropenem act synergistically against these strains. Thirty-five P. aeruginosa and 25 A. baumannii strains that were found to be MDR were included the study. Isolates were collected from the specimens of patients in ICUs from 2001 to 2003. All isolates were identified by standard methods and stored at −20 °C until use. Antibiotic powders of azithromycin, doxycycline, rifampicin, meropenem and colistin were obtained from their manufacturers. Minimum inhibitory concentrations (MICs) were determined by the agar dilution method on Mueller–Hinton agar. Five strains of A. baumannii and five strains of P. aeruginosa, all of which had different MIC values for colistin, were selected for the synergy study using the checkerboard titration method. The susceptibility results for doxycycline and meropenem were interpreted according to National Committee for Clinical Laboratory Standards guidelines. The susceptibility breakpoints for colistin and rifampicin were established as 4 mg/L and 2 mg/L, respectively, based on previous studies. Pseudomonas aeruginosa ATCC 27853 and Escherichia coli ATCC 25922 were used as control strains. Testing against the P. aeruginosa strains revealed high MIC 50 values for all the drugs except colistin. Doxycycline and colistin were both effective against the A. baumannii strains, with high susceptibility rates of 92% and 100%, respectively. Azithromycin had a high MIC 50 value against these strains, whilst rifampicin had a moderate effect (susceptibility rate 64%). The combination of colistin and rifampicin was fully synergistic against four A. baumannii and two P. aeruginosa strains. Combinations of colistin with meropenem and of colistin with azithromycin each showed synergistic activity against three A. baumannii isolates, whilst the same combinations resulted in generally additive or indifferent effects against P. aeruginosa strains. The colistin and doxycycline combination was generally partially synergistic or additive against all the isolates. MDR strains of P. aeruginosa and A. baumannii, which cause nosocomial infections with an increasing ratio in recent years, have limited treatment options. According to our in vitro study results, non-traditional antibiotics such as doxycycline and colistin can be an alternative for the treatment of infections caused by these strains. Combinations of colistin with non-traditional antibiotics or meropenem could be promising alternatives for the treatment of infections due to MDR strains of A. baumannii and P. aeruginosa.</abstract><cop>London</cop><cop>Amsterdam</cop><cop>New York, NY</cop><pub>Elsevier B.V</pub><pmid>16464562</pmid><doi>10.1016/j.ijantimicag.2005.10.012</doi><tpages>5</tpages></addata></record>
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subjects Acinetobacter baumannii
Acinetobacter baumannii - drug effects
Acinetobacter baumannii - isolation & purification
Acinetobacter Infections - drug therapy
Acinetobacter Infections - microbiology
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
Colistin
Drug Resistance, Multiple, Bacterial
Drug Synergism
Drug Therapy, Combination
Escherichia coli
Humans
Intensive Care Units
Medical sciences
Microbial Sensitivity Tests
Multidrug-resistant
Non-traditional antimicrobials
Pharmacology. Drug treatments
Pseudomonas aeruginosa
Pseudomonas aeruginosa - drug effects
Pseudomonas aeruginosa - isolation & purification
Pseudomonas Infections - drug therapy
Pseudomonas Infections - microbiology
Synergy
title In vitro activities of non-traditional antimicrobials alone or in combination against multidrug-resistant strains of Pseudomonas aeruginosa and Acinetobacter baumannii isolated from intensive care units
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