Effectiveness of a double-carbapenem combinations against carbapenem-resistant Gram-negative bacteria

Saudi Pharmaceutical Journal

Rong Zhang¹  Zhangqi Shen²  Qiao Shentu³  Yingqian Wu⁴  Congcong Liu⁵  Qiaoling Sun⁵  Jiayue Lu⁵  Yan Qing⁵  Yu Zeng⁵  Hongwei Zhou⁵  Lixing Huang⁶  Ning Dong⁷ 

[1] Corresponding authors at: Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing 100000, China. (Z. Shen). Department of Clinical Laboratory, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China. (R. Zhang).;Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing 100000, China;Department of Clinical Laboratory, Dongyang Red Cross Hospital, Dongyang 322100, China;Department of Clinical Laboratory, Lanxi People's Hospital, Lanxi 321100, China;Department of Clinical Laboratory, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China;Department of Clinical Laboratory, Taijiang People's Hospital, Taijiang 350004, China;Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong;

关键词: Carbapenem-resistant;    Double-carbapenem regimen;    Combination;    Synergistic activity;    In vitro;   

DOI  :  

来源: DOAJ

【 摘 要 】

The emergence of carbapenem-resistant organisms posed considerable threat to global health while only limited treatment options are available and led to efforts to discover a novel way to treat them. To evaluate in vitro synergistic activity of meropenem plus ertapenem, a total of 203 carbapenem-resistant strains, collected from 12 provinces and municipalities in China, were examined with a dual carbapenem combination therapy. The statistical software R was used for analysis. Two hundred and one (201) of carbapenem-resistant strains mainly produced four types of carbapenemase: KPC-2 (n = 142, 69.95%), OXA-232 (n = 7, 3.45%), NDM (n = 38, 18.72%; 36 NDM-1, 1 NDM-4, 1 NDM-5), and IMP (n = 15, 7.39%; 1 IMP-26, 10 IMP-30, 4 IMP-4). Fifty-one out of two hundred and three (51/203 or 25.12%) of the examined strains showed a synergistic effect for the meropenem plus ertapenem combination throughout the checkerboard method, while only three isolates showed potential clinically relevant synergy (3/203, 1.48%). An additive effect was observed in 55/203 (27.09%) of the examined strains. Ninety-seven of the examined isolates (47.78%) showed fractional inhibitory concentration (FIC) greater or equal to 2 (indicating antagonism). The synergistic activity of meropenem plus ertapenem combination suggests this combination can be a possible way to treat the infection caused by the carbapenem-resistant organisms, especially for IMP or NDM producer with a lesser minimum inhibitory concentration (MIC) and the infected individual who was not recommended to use colistin or tigecycline.

【 授权许可】

Unknown