In vitro activity of amikacin combined with meropenem, colistin and ceftazidime/avibactam against genetically distinct multidrug-resistant K. pneumoniae, A. baumannii and S. marcescens isolates using three methods

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease Pub Date : 2025-05-10 DOI:10.1016/j.diagmicrobio.2025.116888

Saidy Vásconez Noguera , Marina Farrel Côrtes , Ana Paula Marchi , Joyce Vanessa Fonseca , Flavia Rossi , Cláudia Maria Dantas de Maio Carrilho , Anna Sara Levin , Silvia Figueiredo Costa , Lauro Vieira Perdigão Neto

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Abstract

Purpose: To evaluate in vitro efficacy of amikacin combined with meropenem, colistin, and ceftazidime/avibactam against diverse multidrug-resistant isolates of K. pneumoniae (n = 40), A. baumannii (n = 20), and S. marcescens (n = 12), using three methods. Methods: Antimicrobial combinations were tested via Epsilometer strip crossing, disk approximation, and time-kill assays. Results: Amikacin combined with colistin and ceftazidime/avibactam showed synergy in 70,0 % (28/40) and 75,0 % (9/12) of K. pneumoniae and S. marcescens isolates. Meropenem showed limited activity in 25,0 % (5/20) of A. baumannii isolates. Minor errors were observed in <50,0 % of isolates, notably with a 25,0 % error rate for amikacin and colistin using disk approximation. Presence of aminoglycoside-modifying enzyme (AMEs) and blaOXA-23 genes in A. baumannii, and AMEs and ESBL genes in Enterobacterales showed low synergy. Conclusion: Amikacin combined with colistin and ceftazidime/avibactam showed promise against Enterobacterales MDR infections but limited efficacy against Acinetobacter, influenced by resistance genes. E-test can be useful for routine laboratory.

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用三种方法研究阿米卡星联合美罗培南、粘菌素和头孢他啶/阿维巴坦对遗传上不同的多药耐药肺炎克雷伯菌、鲍曼不动杆菌和粘质链球菌的体外活性

目的：采用三种方法评价阿米卡星联合美罗培南、粘菌素、头孢他啶/阿维巴坦对多种多重耐药肺炎克雷伯菌（40株）、鲍曼不动杆菌（20株）和粘质不动杆菌（12株）的体外疗效。方法：采用Epsilometer条带交叉法、圆盘近似法和时效法对抗菌药物组合进行检测。结果：阿米卡星与粘菌素、头孢他啶/阿维巴坦联用对分离的肺炎克雷伯菌和粘质葡萄球菌分别有70%（28/40）和75.0%（9/12）的协同作用。美罗培南对25.0%（5/20）鲍曼不动杆菌分离株的活性有限。在50.0%的分离株中观察到轻微的错误，特别是使用圆盘近似法对阿米卡星和粘菌素的错误率为25.0%。鲍曼不动杆菌中存在氨基糖苷修饰酶（AMEs）和blaOXA-23基因，肠杆菌中存在AMEs和ESBL基因的协同作用较低。结论：阿米卡星联合粘菌素和头孢他啶/阿维巴坦对耐多药肠杆菌感染有良好的治疗效果，但受耐药基因的影响，对不动杆菌的治疗效果有限。E-test可用于常规实验室。

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来源期刊

Diagnostic microbiology and infectious disease 医学-传染病学

CiteScore

5.30

自引率

3.40%

发文量

149

审稿时长

56 days

期刊介绍： Diagnostic Microbiology and Infectious Disease keeps you informed of the latest developments in clinical microbiology and the diagnosis and treatment of infectious diseases. Packed with rigorously peer-reviewed articles and studies in bacteriology, immunology, immunoserology, infectious diseases, mycology, parasitology, and virology, the journal examines new procedures, unusual cases, controversial issues, and important new literature. Diagnostic Microbiology and Infectious Disease distinguished independent editorial board, consisting of experts from many medical specialties, ensures you extensive and authoritative coverage.