Synergistic antibiotic combinations for colistin-resistant Klebsiella pneumoniae

Kádár, Béla and Kocsis, Béla and Tóth, Ákos and Damjanova, Ivelina and Szász, Máté and Kristóf, Katalin and Nagy, Károly and Szabó, Dóra (2013) Synergistic antibiotic combinations for colistin-resistant Klebsiella pneumoniae. Acta Microbiologica et Immunologica Hungarica, 60 (2). pp. 201-209. ISSN 1217-8950

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Abstract

In this study antibiotic combinations for multidrug-resistant Klebsiella pneumoniae strains were investigated. The study included a colistin-susceptible and a colistin-resistant KPC-2 producing K. pneumoniae ST258 strains isolated in 2008 and 2009 during an outbreak in Hungary. Antibiotic combinations were analyzed by checkerboard technique and fractional inhibitory concentration indices were calculated. The following antibiotics were tested: ceftazidime, cefotaxime, ceftriaxone, ampicillin, imipenem, ertapenem, amikacin, tobramycin, ciprofloxacin, levofloxacin, moxifloxacin, rifampicin, polymyxin B and colistin. Combinations including 0.25 μg/ml colistin plus 1 μg/ml rifampicin, 0.25 μg/ml polymyxin B plus 1 μg/ml rifampicin, 1 μg/ml imipenem plus 2 μg/ml tobramycin, were found synergistic.These in vitro synergistic combinations suggest potential therapeutical options against infections caused by KPC-2 producing, multidrug-resistant K. pneumoniae ST258.

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