title: Synergistic antibiotic combinations for colistin-resistant Klebsiella pneumoniae.
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.
authors.affiliation: Semmelweis University, Institue of Medical Microbiology, Budapest, Hungary.
authors.forename: Béla
authors.initials: B
authors.lastname: Kádár
authors.forename: Béla
authors.initials: B
authors.lastname: Kocsis
authors.forename: Ákos
authors.initials: Á
authors.lastname: Tóth
authors.forename: Ivelina
authors.initials: I
authors.lastname: Damjanova
authors.forename: Máté
authors.initials: M
authors.lastname: Szász
authors.forename: Katalin
authors.initials: K
authors.lastname: Kristóf
authors.forename: Károly
authors.initials: K
authors.lastname: Nagy
authors.forename: Dóra
authors.initials: D
authors.lastname: Szabó
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002442:Ceftazidime / Q000494:pharmacology; D003091:Colistin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004357:Drug Synergism; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D014031:Tobramycin / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D015378:Imipenem; D002442:Ceftazidime; D014031:Tobramycin; D003091:Colistin