In Vitro activities of combinations of rifampin with other antimicrobials against multidrug-resistant Acinetobacter baumannii.

Yan Bai, Bin Liu, Tianlin Wang, Yun Cai, Beibei Liang, Rui Wang, Youning Liu, Jin Wang
Author Information
  1. Yan Bai: Department of Pharmaceutical Care, Chinese PLA General Hospital, Beijing, China.
  2. Bin Liu: Department of Respiratory Diseases, Chinese PLA General Hospital, Beijing, China.
  3. Tianlin Wang: Department of Pharmaceutical Care, Chinese PLA General Hospital, Beijing, China.
  4. Yun Cai: Center of Medicine Clinical Research, Translational Medical Center, Chinese PLA General Hospital, Beijing, China.
  5. Beibei Liang: Center of Medicine Clinical Research, Translational Medical Center, Chinese PLA General Hospital, Beijing, China.
  6. Rui Wang: Center of Medicine Clinical Research, Translational Medical Center, Chinese PLA General Hospital, Beijing, China 362337166@qq.com.
  7. Youning Liu: Department of Respiratory Diseases, Chinese PLA General Hospital, Beijing, China.
  8. Jin Wang: Center of Medicine Clinical Research, Translational Medical Center, Chinese PLA General Hospital, Beijing, China.

Abstract

The antimicrobial treatment of multidrug-resistant (MDR) Acinetobacter baumannii infections has become a great challenge for medical staff all over the world. Increasing numbers of MDR A. baumannii infections have been identified and reported, but effective clinical treatments for them are decreasing. The objective of this study was to investigate the in vitro activities of combinations of rifampin (an established antimicrobial) and other antimicrobials, including biapenem, colistin, and tigecycline, against 73 clinical isolates of MDR A. baumannii. In total, 73 clinical isolates of MDR A. baumannii were collected from two A-level general hospitals in Beijing, and the MICs of rifampin, biapenem, colistin, and tigecycline were determined. The checkerboard method was used to determine the fractional inhibitory concentration indices (FICIs), that is, whether the combinations acted synergistically against these isolates. The MIC50, MIC90, and MICrange of rifampin combined with biapenem, colistin, and tigecycline against the isolates were clearly lower than those for four antimicrobials (rifampin, biapenem, colistin, and tigecycline) that were used alone. Combinations of rifampin with biapenem, colistin, and tigecycline individually demonstrated the following interactions: synergistic interactions (FICI ≤ 0.5) for 31.51%, 34.25%, and 31.51% of the isolates, partially synergistic interactions (0.5 < FICI < 1) for 49.31%, 43.83%, and 47.94% of the isolates, and additive interactions (FICI = 1) for 19.18%, 21.92%, and 20.55% of the isolates, respectively. There were no indifferent (1 < FICI < 4) or antagonistic (FICI ≥ 4) interactions. Therefore, combinations of rifampin with biapenem, colistin, or tigecycline may be future therapeutic alternatives for the treatment of MDR A. baumannii infections.

References

  1. Int J Antimicrob Agents. 2006 Mar;27(3):224-8 [PMID: 16464562]
  2. J Antimicrob Chemother. 2006 Sep;58(3):689-92 [PMID: 16870647]
  3. J Infect. 2006 Oct;53(4):274-8 [PMID: 16442632]
  4. Clin Microbiol Infect. 2006 Nov;12(11):1147-9 [PMID: 17063597]
  5. J Antimicrob Chemother. 2007 Apr;59(4):772-4 [PMID: 17353223]
  6. Diagn Microbiol Infect Dis. 2007 Jul;58(3):357-61 [PMID: 17467946]
  7. J Clin Microbiol. 2007 Dec;45(12):4054-7 [PMID: 17942662]
  8. N Engl J Med. 2008 Mar 20;358(12):1271-81 [PMID: 18354105]
  9. Int J Antimicrob Agents. 2008 May;31(5):434-9 [PMID: 18328674]
  10. Clin Infect Dis. 2008 Apr 1;46(7):1121-2; author reply 1122 [PMID: 18444833]
  11. Clin Microbiol Rev. 2008 Jul;21(3):538-82 [PMID: 18625687]
  12. BMC Microbiol. 2009;9:270 [PMID: 20028528]
  13. J Antimicrob Chemother. 2010 Feb;65(2):233-8 [PMID: 19996144]
  14. Antimicrob Agents Chemother. 2010 Mar;54(3):1165-72 [PMID: 20047914]
  15. Antimicrob Agents Chemother. 2010 Dec;54(12):5316-22 [PMID: 20876375]
  16. J Antibiot (Tokyo). 2010 Nov;63(11):657-9 [PMID: 20877368]
  17. J Antimicrob Chemother. 2011 May;66(5):1047-51 [PMID: 21393131]
  18. J Chemother. 2011 Feb;23(1):13-6 [PMID: 21482488]
  19. J Crit Care. 2011 Oct;26(5):453-9 [PMID: 21439763]
  20. Diagn Microbiol Infect Dis. 1993 Nov-Dec;17(4):299-305 [PMID: 8112045]
  21. J Antimicrob Chemother. 1994 May;33(5):949-58 [PMID: 8089068]
  22. Int J Antimicrob Agents. 2005 Jun;25(6):523-9 [PMID: 15885987]
  23. Diagn Microbiol Infect Dis. 2005 Aug;52(4):317-22 [PMID: 15936166]
  24. Clin Microbiol Infect. 2012 Mar;18(3):268-81 [PMID: 21793988]
  25. J Chemother. 2012 Apr;24(2):87-92 [PMID: 22546763]
  26. J Antimicrob Chemother. 2012 Jul;67(7):1607-15 [PMID: 22441575]
  27. Am J Respir Crit Care Med. 2012 Sep 15;186(6):559-65 [PMID: 22744719]
  28. J Chemother. 2012 Oct;24(5):247-52 [PMID: 23182043]
  29. Int J Antimicrob Agents. 2013 Jan;41(1):11-9 [PMID: 23127486]
  30. Int J Antimicrob Agents. 2013 Mar;41(3):285-7 [PMID: 23312607]
  31. J Infect Chemother. 2013 Feb;19(1):98-102 [PMID: 22926665]
  32. Antimicrob Agents Chemother. 2002 Jun;46(6):1946-52 [PMID: 12019113]
  33. Eur J Clin Microbiol Infect Dis. 2013 Oct;32(10):1291-4 [PMID: 23609511]
  34. J Infect Chemother. 2014 Jun;20(6):356-60 [PMID: 24725621]
  35. Antimicrob Agents Chemother. 2014 Dec;58(12):7324-30 [PMID: 25267662]

MeSH Term

Acinetobacter baumannii
Anti-Infective Agents
Drug Resistance, Multiple, Bacterial
Drug Therapy, Combination
Humans
Microbial Sensitivity Tests
Rifampin

Chemicals

Anti-Infective Agents
Rifampin

Word Cloud

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