2026-04-29T06:15:54Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/227002024-11-29T00:07:36Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967col_20.500.12105_16983

00925njm 22002777a 4500 dc Montero, Maria M author Domene-Ochoa, Sandra author López-Causapè, Carla author VanScoy, Brian author Luque, Sonia author Sorli, Luisa author Campillo, Nuria author Padilla, Eduardo author Prim, Nuria author Segura, Concepcion author Pomar, Virginia author Rivera, Alba author Grau, Santiago author Ambrose, Paul G author Oliver, Antonio author Horcajada, Juan P author 2019-09 Background: Extensively drug-resistant (XDR) Pseudomonas aeruginosa (P. aeruginosa) and particularly P. aeruginosa high-risk clones, are of growing concern because treatment options are limited. For years, colistin monotherapy has been the only available treatment, but is well known that is not an optimal treatment. A combination of colistin with another antibiotic could be a possible therapeutic option. Objectives: This study aimed to investigate effective antibiotic combinations against 20 XDR P. aeruginosa isolates obtained in a Spanish multicentre study (2015). Methods: Forty-five checkerboards with six antipseudomonal antibiotics (amikacin, aztreonam, ceftazidime, meropenem, colistin, and ceftolozane/tazobactam) were performed to determine whether combinations were synergic or additive by fractional inhibitory concentration indices. On average, 15 different regimens were evaluated in duplicate against the three most prevalent high-risk clones (ST175, ST235, ST111) by time-kill analyses over 24 h. The combination showing synergism in the three high-risk clones was validated in all studied XDR isolates. Results: In time-kill curves, the untreated control failed, as did each study regimen when administered alone. Two combinations were synergistic in the three high-risk clones that were initially studied: amikacin plus ceftazidime and colistin plus meropenem, with the second being the most effective combination. The efficacy of colistin plus meropenem was then tested in all 20 isolates. A synergistic bacterial density reduction for the duration of the study occurred in 80% of the entire XDR collection. Conclusions: These data suggest that colistin plus meropenem may be a useful combination for the treatment of infections due to XDR P. aeruginosa, including high-risk clones, which warrants evaluation in a clinical trial. Montero Maria M., Domene Ochoa Sandra, López-Causapè Carla, Vanscoy Brian, Luque Sonia, Sorli Luisa, et al. Colistin plus meropenem combination is synergistic in vitro against extensively drug-resistant Pseudomonas aeruginosa, including high-risk clones. J Glob Antimicrob Resist. 2019 Sep;18:37-44. Epub 2019 May 30. 2213-7165 http://hdl.handle.net/20.500.13003/15231 https://hdl.handle.net/20.500.12105/22700 31154007 10.1016/j.jgar.2019.04.012 2213-7173 Journal of Global Antimicrobial Resistance 2-s2.0-85067395021 485661700007 L2002134467 Colistin Meropenem Combination therapy Pseudomonas aeruginosa Synergy Colistin plus meropenem combination is synergistic in vitro against extensively drug-resistant Pseudomonas aeruginosa, including high-risk clones