Three Dimensional Checkerboard Synergy Analysis of Colistin, Meropenem, Tigecycline against Multidrug-Resistant Clinical Klebsiella pneumonia Isolates
dc.contributor.author | Stein, Claudia | |
dc.contributor.author | Makarewic, Oliwia | |
dc.contributor.author | Bohnert, Jürgen A. | |
dc.contributor.author | Pfeifer, Yvonne | |
dc.contributor.author | Kesselmeier, Miriam | |
dc.contributor.author | Hagel, Stefan | |
dc.contributor.author | Pletz, Mathias W. | |
dc.date.accessioned | 2018-05-07T18:20:43Z | |
dc.date.available | 2018-05-07T18:20:43Z | |
dc.date.created | 2015-08-04 | |
dc.date.issued | 2015-06-11 | none |
dc.identifier.other | http://edoc.rki.de/oa/articles/reXKfq3VOdkTM/PDF/27PBJJMZBngt2.pdf | |
dc.identifier.uri | http://edoc.rki.de/176904/2094 | |
dc.description.abstract | The spread of carbapenem-non-susceptible Klebsiella pneumoniae strains bearing different resistance determinants is a rising problem worldwide. Especially infections with KPC (Klebsiella pneumoniae carbapenemase) - producers are associated with high mortality rates due to limited treatment options. Recent clinical studies of KPC-blood stream infections revealed that colistin-based combination therapy with a carbapenem and/or tigecycline was associated with significantly decreased mortality rates when compared to colistin monotherapy. However, it remains unclear if these observations can be transferred to K. pneumoniae harboring other mechanisms of carbapenem resistance. A three-dimensional synergy analysis was performed to evaluate the benefits of a triple combination with meropenem, tigecycline and colistin against 20 K. pneumoniae isolates harboring different β-lactamases. To examine the mechanism behind the clinically observed synergistic effect, efflux properties and outer membrane porin (Omp) genes (ompK35 and ompK36) were also analyzed. Synergism was found for colistin-based double combinations for strains exhibiting high minimal inhibition concentrations against all of the three antibiotics. Adding a third antibiotic did not result in further increased synergistic effect in these strains. Antagonism did not occur. These results support the idea that colistin-based double combinations might be sufficient and the most effective combination partner for colistin should be chosen according to its MIC. | eng |
dc.language.iso | eng | |
dc.publisher | Robert Koch-Institut, Infektionskrankheiten / Erreger | |
dc.subject | Bacterial Proteins/metabolism | eng |
dc.subject | Anti-Bacterial Agents/pharmacology | eng |
dc.subject | Microbial Sensitivity Tests | eng |
dc.subject | Colistin/pharmacology | eng |
dc.subject | Drug Resistance Multiple Bacterial/drug effects | eng |
dc.subject | Drug Synergism | eng |
dc.subject | Gene Expression Regulation Bacterial/drug effects | eng |
dc.subject | Klebsiella pneumoniae/drug effects | eng |
dc.subject | Klebsiella pneumoniae/enzymology | eng |
dc.subject | Klebsiella pneumoniae/isolation & purification | eng |
dc.subject | Minocycline/analogs & derivatives | eng |
dc.subject | Minocycline/pharmacology | eng |
dc.subject | Porins/metabolism | eng |
dc.subject | Thienamycins/pharmacology | eng |
dc.subject.ddc | 610 Medizin | |
dc.title | Three Dimensional Checkerboard Synergy Analysis of Colistin, Meropenem, Tigecycline against Multidrug-Resistant Clinical Klebsiella pneumonia Isolates | |
dc.type | periodicalPart | |
dc.identifier.urn | urn:nbn:de:0257-10040011 | |
dc.identifier.doi | 10.1371/journal.pone.0126479 | |
dc.identifier.doi | http://dx.doi.org/10.25646/2019 | |
local.edoc.container-title | PLoS ONE | |
local.edoc.container-text | Stein C, Makarewicz O, Bohnert JA, Pfeifer Y, Kesselmeier M, Hagel S, et al. (2015) Three Dimensional Checkerboard Synergy Analysis of Colistin, Meropenem, Tigecycline against Multidrug-Resistant Clinical Klebsiella pneumonia Isolates. PLoS ONE 10(6): e0126479. | |
local.edoc.fp-subtype | Artikel | |
local.edoc.type-name | Zeitschriftenartikel | |
local.edoc.container-type | periodical | |
local.edoc.container-type-name | Zeitschrift | |
local.edoc.container-url | http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0126479 | |
local.edoc.container-publisher-name | Public Library of Science | |
local.edoc.container-volume | 10 | |
local.edoc.container-issue | 6 | |
local.edoc.container-year | 2015 |