title: [In vitro activities of colistin combinations against Pseudomonas aeruginosa isolated from the intensive care unit].
abstract: Introduction. As the number of multidrug-resistant strains of Pseudomonas aeruginosa has risen in the intensive care unit (ICU) of the San Carlos Clinic Hospital, 12 consecutive isolates from different patients were collected to determine the possibility of an epidemic outbreak caused by the spread of a single strain. We determined the antimicrobial susceptibility to the most common agents used in the treatment of infections caused by this bacteria. The results of susceptibility studies suggest that different strains of P. aeruginosa are responsible for the respiratory tract infections in ICU. Methods. The clonal relationship between the isolates using was determined using BOX and ERIC primers by means of repetitive sequence-based polymerase chain reaction (rep-PCR). The in vitro activity of these strains against colistin, rifampicin, doxicycline and azythromycin was studied to determine in which cases the combination of colistin with any of the other three antibiotics was synergistic. Results. Sensitivity studies point out the presence of several strains of P. aeruginosa as the causal agents of respiratory infections produced by this microorganism in the ICU. Combinations of colistin with doxycicline and colistin with azithromycin were synergistic for some isolates in the synergy studies. Discussion. Clonal studies reveal the presence of five different clones among our isolates. Therefore we can conclude that there was no outbreak of P. aeruginosa in the ICU. Synergistic activity of combinations of colistin plus azithromycin, colistin plus doxicycline and colistin plus rifampicin was less than expected and a high percentage of indifferent results was observed.
authors.affiliation: Servicio de Microbiología, Hospital Clínico San Carlos, Madrid. fatimalopez0210@yahoo.es
authors.forename: F
authors.initials: F
authors.lastname: López-Fabal
authors.forename: E
authors.initials: E
authors.lastname: Culebras
authors.forename: I
authors.initials: I
authors.lastname: Bonilla
authors.forename: M
authors.initials: M
authors.lastname: Gómez
authors.forename: J J
authors.initials: JJ
authors.lastname: Picazo
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D003091:Colistin / Q000008:administration & dosage*; D004318:Doxycycline / Q000008:administration & dosage*; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D012293:Rifampin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin; D004318:Doxycycline; D012293:Rifampin; D003091:Colistin