Journal
BIOMED RESEARCH INTERNATIONAL
Volume 2015, Issue -, Pages -Publisher
HINDAWI LTD
DOI: 10.1155/2015/568079
Keywords
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Funding
- Centers for Disease Control and Prevention [DOH98-DC-1005]
- Department of Health
- Executive Yuan, Taiwan
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We investigated the synergism of colistin and imipenem against a multidrug-resistant K. pneumoniae isolate which was recovered from a severe hip infection. PCR and DNA sequencing were used to characterize the outermembrane porin genes and the resistance genes mediating the common beta-lactamases and carbapenemases. Synergism was evaluated by time-kill studies. The bla(SHV-31), bla(CMY-2), and bla(DHA-1) were detected. Outer membrane porin genes analysis revealed loss of ompK36 and frame-shift mutation of ompK35. The common carbapenemase genes were not found. Time-kill studies demonstrated that a combination of 1x MIC of colistin (2 mg/L) and 1x MIC of imipenem (8 mg/L) was synergistic and bactericidal but with inoculum effect. Bactericidal activity without inoculum effect was observed by concentration of 2x MIC of colistin alone or plus 2x MIC of imipenem. In conclusion, colistin plus imipenem could be an alternative option to treat carbapenem-resistant K. pneumoniae infections.
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