Potent Synergy and Sustained Bactericidal Activity of a Vancomycin-Colistin Combination versus Multidrug-Resistant Strains of Acinetobacter baumannii
Potent Synergy and Sustained Bactericidal Activity of a Vancomycin-Colistin Combination versus Multidrug-Resistant Strains of Acinetobacter baumannii
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DOI：
10.1128/aac.00922-10
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发表时间：
2010-12-01
影响因子：
4.9
通讯作者：
Wareham, D. W.
中科院分区：
文献类型：
--
作者：
Gordon, N. C.;Png, K.;Wareham, D. W.
耐多药鲍曼不动杆菌（MDRAB）对卫生保健提出了越来越大的挑战。虽然粘菌素已被用作最后的治疗手段，但人们担心其潜在的毒性和耐药性的出现。然而，粘菌素的作用机制提高了与通常对革兰氏阴性菌无活性的化合物协同作用的可能性，因为细菌外膜的不渗透性。本研究通过时间杀灭法、微量稀释法和Etest方法，评估了粘菌素联合万古霉素对5种先前鉴定的流行菌株和34株MDRAB临床分离株的影响。对所有分离株，至少有一种方法证明了显著的协同作用，万古霉素的MIC从bb0 - 256 μ g/ml降至
Multidrug-resistant Acinetobacter baumannii (MDRAB) presents an increasing challenge to health care. Although colistin has been used as a treatment of last resort, there is concern regarding its potential for toxicity and the emergence of resistance. The mechanism of action of colistin, however, raises the possibility of synergy with compounds that are normally inactive against Gram-negative organisms by virtue of the impermeability of the bacterial outer membrane. This study evaluated the effect of colistin combined with vancomycin on 5 previously characterized epidemic strains and 34 MDRAB clinical isolates by using time-kill assay, microdilution, and Etest methods. For all the isolates, significant synergy was demonstrated by at least one method, with reductions in the MIC of vancomycin from > 256 mu g/ml to