期刊
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE
卷 91, 期 2, 页码 169-174出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.diagmicrobio.2018.01.008
关键词
Acinetobacter baumannii; Carbapenem resistance; Antibiotic combination
资金
- Chulalongkorn University Graduate Scholarship
- Anniversary of Chulalongkorn University Fund (Ratchadaphiseksompot Endowment Fund) from the Chulalongkorn University Graduate School
- Research Grant for Graduate Studies from the National Research Council of Thailand
Carbapenem-resistant Acinetobacter baumannii clinical isolates (n=23) were investigated for carbapenem resistance mechanisms and in vitro activities of carbapenems in combination with amikacin, colistin, or fosfomycin. Major carbapenem resistance mechanism was OXA-23 production. The vast majority of these isolates were OXA-23-producing A. baumannii ST195 and ST542, followed by novel STs, ST1417, and ST1423. The interuption of car by a novel insertion sequence, ISAba40, was found in two isolates. The combinations of imipenem and fosfomycin, meropenem and amikacin, imipenem and amikacin, and imipenem and colistin were synergistic against carbapenem-resistant A. baumannii by 65.2%, 46.2%, 30.8%, and 17.4%, respectively. Surprisingly, the combination of imipenem and fosfomycin was the most effective in this study against A. baumannii, which is intrinsically resistant to fosfomycin. Imipenem and fosfomycin inhibit cell wall synthesis; therefore, fosfomycin may be an adjuvant and enhance the inhibition of cell wall synthesis of carbapenem-resistant A. baumannii when combined with imipenem. (C) 2018 Elsevier Inc. All rights reserved.
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