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In Vitro Antibiotic Combinations of Colistin, Meropenem, Amikacin, and Amoxicillin/Clavulanate Against Multidrug-Resistant Klebsiella Pneumonia Isolated From Patients With Ventilator-Associated Pneumonia Publisher Pubmed



Bayatinejad G1 ; Salehi M2, 3 ; Beigverdi R1 ; Halimi S1 ; Emaneini M1 ; Jabalameli F1, 3
Authors
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Authors Affiliations
  1. 1. Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Tehran University of Medical Sciences, Tehran, Iran

Source: BMC Microbiology Published:2023


Abstract

Background: Hospital infections such as ventilator-associated pneumonia (VAP) due to multidrug-resistant Klebsiella pneumoniae (MDR-KP) strains have increased worldwide. In addition, biofilm production by these resistant isolates has confronted clinicians with higher treatment failure and infection recurrence. Given the paucity of new agents and limited data on combination therapy for MDR-KPs, the present study sought to evaluate the in vitro activity of several antibiotic combinations against planktonic and biofilm MDR-KPs isolated from patients with VAP. Results: All 10 carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates demonstrated multidrug resistance against the tested antibiotics. At planktonic mode, combinations of colistin-meropenem and amoxicillin/clavulanate in combination with meropenem, colistin, or amikacin showed synergism against 60–70% isolates. On the other hand, in the biofilm state, colistin-based combinations exhibited synergism against 50–70% isolates and the most effective combination was colistin-amikacin with 70% synergy. Conclusions: The results revealed that combinations of amoxicillin/clavulanate with colistin, meropenem, or amikacin in the planktonic mode and colistin with amoxicillin/clavulanate, meropenem, or amikacin in the biofilm mode could effectively inhibit CRKP isolates, and thus could be further explored for the treatment of CRKPs. © 2023, BioMed Central Ltd., part of Springer Nature.
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