title: In vitro interactions of antimicrobial combinations with fosfomycin against KPC-2-producing Klebsiella pneumoniae and protection of resistance development.
abstract: Using time-kill methodology, we investigated the interactions of fosfomycin with meropenem or colistin or gentamicin against 17 genetically distinct Klebsiella pneumoniae clinical isolates carrying blaKPC-2. Synergy was observed with meropenem or colistin against 64.7 and 11.8% of tested isolates, while the combination with gentamicin resulted in indifference. All studied combinations showed improved bactericidal activity, compared to fosfomycin alone and prevented the development of fosfomycin resistance in 69.2, 53.8, and 81.8% of susceptible isolates, respectively.
authors.affiliation: 4th Department of Internal Medicine, Athens University School of Medicine, University General Hospital Attikon, 1 Rimini Str., 124 62 Chaidari, Greece. msouli@med.uoa.gr
authors.forename: Maria
authors.initials: M
authors.lastname: Souli
authors.forename: Irene
authors.initials: I
authors.lastname: Galani
authors.forename: Stefanos
authors.initials: S
authors.lastname: Boukovalas
authors.forename: Michael George
authors.initials: MG
authors.lastname: Gourgoulis
authors.forename: Zoi
authors.initials: Z
authors.lastname: Chryssouli
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Kanellakopoulou
authors.forename: Theofano
authors.initials: T
authors.lastname: Panagea
authors.forename: Helen
authors.initials: H
authors.lastname: Giamarellou
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology*; D003091:Colistin / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial; D004357:Drug Synergism; D005578:Fosfomycin / Q000494:pharmacology*; D005839:Gentamicins / Q000494:pharmacology; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology* / Q000235:genetics; D000077731:Meropenem; D008826:Microbial Sensitivity Tests; D013845:Thienamycins / Q000494:pharmacology; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000890:Anti-Infective Agents; D005839:Gentamicins; D013845:Thienamycins; D005578:Fosfomycin; C491478:beta-lactamase KPC-2; D001618:beta-Lactamases; D000077731:Meropenem; D003091:Colistin