Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0018485
Title: In-vitro activity of polymyxin B, rifampicin, tigecycline alone and in combination against Carbapenem-resistant Acinetobacter baumannii in Singapore
Authors: Lim T.-P. 
Tan T.-Y.
Lee W.
Sasikala S.
Tan T.-T. 
Hsu L.-Y. 
Kwa A.L. 
Keywords: polymyxin B
rifampicin
tigecycline
antiinfective agent
carbapenem derivative
drug derivative
minocycline
polymyxin B
rifampicin
tigecycline
Acinetobacter baumannii
antibacterial activity
antibiotic resistance
antibiotic sensitivity
article
bactericidal activity
bacterium isolate
combination chemotherapy
controlled study
drug efficacy
in vitro study
minimum inhibitory concentration
monotherapy
multidrug resistance
nonhuman
Singapore
classification
drug effect
Acinetobacter baumannii
Acinetobacter baumannii
Anti-Bacterial Agents
Carbapenems
Drug Resistance, Microbial
Minocycline
Polymyxin B
Rifampin
Singapore
Issue Date: 2011
Citation: Lim T.-P., Tan T.-Y., Lee W., Sasikala S., Tan T.-T., Hsu L.-Y., Kwa A.L. (2011). In-vitro activity of polymyxin B, rifampicin, tigecycline alone and in combination against Carbapenem-resistant Acinetobacter baumannii in Singapore. PLoS ONE 6 (4) : e18485. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0018485
Abstract: Objective: Carbapenem-resistant Acinetobacter baumannii (CR-AB) is an emerging cause of nosocomial infections worldwide. Combination therapy may be the only viable option until new antibiotics become available. The objective of this study is to identify potential antimicrobial combinations against CR-AB isolated from our local hospitals. Methods: AB isolates from all public hospitals in Singapore were systematically collected between 2006 and 2007. MICs were determined according to CLSI guidelines. All CR-AB isolates were genotyped using a PCR-based method. Clonal relationship was elucidated. Time-kill studies (TKS) were conducted with polymyxin B, rifampicin and tigecycline alone and in combination using clinically relevant (achievable) unbound concentrations. Results: 31 CR AB isolates were identified. They are multidrug-resistant, but are susceptible to polymyxin B. From clonal typing, 8 clonal groups were identified and 11 isolates exhibited clonal diversity. In single TKS, polymyxin B, rifampicin and tigecycline alone did not exhibit bactericidal activity at 24 hours. In combination TKS, polymyxin plus rifampicin, polymyxin B plus tigecycline and tigecycline plus rifampicin exhibited bactericidal killing in 13/31, 9/31 and 7/31 isolates respectively at 24 hours. Within a clonal group, there may be no consensus with the types of antibiotics combinations that could still kill effectively. Conclusion: Monotherapy with polymyxin B may not be adequate against polymyxin B susceptible AB isolates. These findings demonstrate that in-vitro synergy of antibiotic combinations in CR AB may be strain dependant. It may guide us in choosing a pre-emptive therapy for CR AB infections and warrants further investigations. © 2011 Lim et al.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/162052
ISSN: 19326203
DOI: 10.1371/journal.pone.0018485
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