In Vitro Antibiotic Combinations of Colistin, Meropenem, Amikacin, and Amoxicillin/clavulanate Against Multidrug-resistant Klebsiella Pneumonia Isolated from Patients with Ventilator-associated Pneumonia

Overview

Journal BMC Microbiol

Publisher Biomed Central

Specialty Microbiology

Date 2023 Oct 20

PMID 37864176

Authors

Ghazal Bayatinejad

Mohammadreza Salehi

Reza Beigverdi

Shahnaz Halimi

Mohammad Emaneini

Fereshteh Jabalameli

Affiliations

Soon will be listed here.

Abstract

Background: Hospital infections such as ventilator-associated pneumonia (VAP) due to multidrug-resistant Klebsiella pneumoniae (MDR-KP) strains have increased worldwide. In addition, biofilm production by these resistant isolates has confronted clinicians with higher treatment failure and infection recurrence. Given the paucity of new agents and limited data on combination therapy for MDR-KPs, the present study sought to evaluate the in vitro activity of several antibiotic combinations against planktonic and biofilm MDR-KPs isolated from patients with VAP.

Results: All 10 carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates demonstrated multidrug resistance against the tested antibiotics. At planktonic mode, combinations of colistin-meropenem and amoxicillin/clavulanate in combination with meropenem, colistin, or amikacin showed synergism against 60-70% isolates. On the other hand, in the biofilm state, colistin-based combinations exhibited synergism against 50-70% isolates and the most effective combination was colistin-amikacin with 70% synergy.

Conclusions: The results revealed that combinations of amoxicillin/clavulanate with colistin, meropenem, or amikacin in the planktonic mode and colistin with amoxicillin/clavulanate, meropenem, or amikacin in the biofilm mode could effectively inhibit CRKP isolates, and thus could be further explored for the treatment of CRKPs.

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