Yongxin Zhao1,2, Chunjiang Li3, Jisheng Zhang1,2, Yanjun Fu2, Kewang Hu2, Shanshan Su2,4, Yong Wang2, Huiling Li2, Xiaoli Zhang1,2. 1. Department of Microbiology, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China. 2. Department of Microbiology, the First Affiliated Hospital of Jiamusi University, Jiamusi 154003, China. 3. Department of Pathogenic Biology, Jiamusi University School of Basic Medicine, Jiamusi 154007, China. 4. The First People's Hospital of Jingzhou City, Jingzhou 434000, China.
Abstract
BACKGROUND: The emergence of carbapenem-resistant Enterobacteriaceae (CRE) has become a significant problem for global public health. Currently, treatments program is minimal. This study aimed to evaluate the molecular mechanisms of carbapenem-resistant Enterobacter cloacae complex isolates (CREC) infections. Methods: Resistance genes were detected using PCR with specific primers. Multilocus sequence typing (MLST) was also performed. Furthermore, we evaluated the effects of polymyxin B (PMB) and tigecycline (TGC) antibiotics (Abs) alone and in combination with meropenem (MEM), amikacin (AMK), and levofloxacin (LEV) against CREC isolates. The results were then compared with in vitro synergy testing results obtained from time-kill assays (TKAs), and the microdilution checkerboard method. RESULTS: The synergistic efficiency of PMB + TGC was also evaluated. Abs use clinically achievable concentrations to determine the antibacterial effects of the Ab. Similar sequence type (ST) classifications had a comparably resistant phenotype; PMB-based combination therapy is better than TGC-based combination therapy. CONCLUSIONS: we found that the combination of PMB + AMK is promising for the treatment of AMK-sensitive CREC. The high-risk ST93 carrying the bla KPC-2 gene should be monitored. 2019 Annals of Translational Medicine. All rights reserved.
BACKGROUND: The emergence of carbapenem-resistant Enterobacteriaceae (CRE) has become a significant problem for global public health. Currently, treatments program is minimal. This study aimed to evaluate the molecular mechanisms of carbapenem-resistant Enterobacter cloacae complex isolates (CREC) infections. Methods: Resistance genes were detected using PCR with specific primers. Multilocus sequence typing (MLST) was also performed. Furthermore, we evaluated the effects of polymyxin B (PMB) and tigecycline (TGC) antibiotics (Abs) alone and in combination with meropenem (MEM), amikacin (AMK), and levofloxacin (LEV) against CREC isolates. The results were then compared with in vitro synergy testing results obtained from time-kill assays (TKAs), and the microdilution checkerboard method. RESULTS: The synergistic efficiency of PMB + TGC was also evaluated. Abs use clinically achievable concentrations to determine the antibacterial effects of the Ab. Similar sequence type (ST) classifications had a comparably resistant phenotype; PMB-based combination therapy is better than TGC-based combination therapy. CONCLUSIONS: we found that the combination of PMB + AMK is promising for the treatment of AMK-sensitive CREC. The high-risk ST93 carrying the bla KPC-2 gene should be monitored. 2019 Annals of Translational Medicine. All rights reserved.
Authors: Jonathan W Betts; Lynette M Phee; Michael Hornsey; Neil Woodford; David W Wareham Journal: Antimicrob Agents Chemother Date: 2014-03-31 Impact factor: 5.191