Activities of Dual Combinations of Antibiotics Against Multidrug-Resistant Nontuberculous Mycobacteria Recovered from Patients with Cystic Fibrosis
| Autor: | Stefanie L. Fisher, Gyanu Lamichhane, Nicole Parrish, Elizabeth Story-Roller, Matthew D. Schwartz |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Cystic Fibrosis medicine.drug_class 030106 microbiology Immunology Antibiotics Mycobacterium Infections Nontuberculous Mycobacterium chelonae Microbial Sensitivity Tests Mycobacterium abscessus medicine.disease_cause Microbiology Clofazimine 03 medical and health sciences Antibiotic resistance Drug Resistance Multiple Bacterial medicine Humans Disease Pharmacology biology business.industry Nontuberculous Mycobacteria Pathogenic bacteria bacterial infections and mycoses biology.organism_classification Anti-Bacterial Agents Multiple drug resistance Nontuberculous mycobacteria business medicine.drug |
| Zdroj: | Microbial Drug Resistance. 24:1191-1197 |
| ISSN: | 1931-8448 1076-6294 |
| Popis: | Patients with cystic fibrosis (CF) are at risk for recurrent pulmonary infections due to increased viscosity of airway secretions, leading to persistent colonization with pathogenic bacteria, including nontuberculous mycobacteria (NTM). Extensive antibiotic use for treatment of infections has led to increasing antimicrobial resistance, which is a significant barrier to the treatment of NTMs. We examined the in vitro activity of several antibiotics against a selection of the most drug-resistant clinical isolates of Mycobacterium abscessus, Mycobacterium chelonae, and Mycobacterium avium complex recovered from CF patients at our institution, as well as paired combinations of antibiotics against a subset of M. abscessus strains, to determine whether they exhibit synergy in inhibiting bacterial growth. Most isolates displayed resistance to at least six of the nine antibiotics tested for which phenotypic interpretation is available, and elevated minimum inhibitory concentrations (MICs) were observed for many of the other drugs. The major exception was clofazimine, which had relatively low MICs for most isolates across all species. When synergy testing was performed by using paired combinations of drugs, clofazamine and clarithromycin exhibited 100% synergy for all combinations tested, as did amikacin, with the exception of one isolate. These results suggest that synergistic antibiotic combinations are capable of overcoming drug resistance in vitro, and laboratories might consider implementation of synergy testing in multidrug-resistant (MDR)-NTM organisms to guide treatment decisions in the setting of extensive antimicrobial resistance. |
| Databáze: | OpenAIRE |
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