Colistin-resistant Enterobacteriaceae infections: clinical and molecular characterization and analysis of in vitro synergy.
Diagn Microbiol Infect Dis
; 87(3): 253-257, 2017 Mar.
Article
en En
| MEDLINE
| ID: mdl-27939820
We described 27 polyclonal colistin-resistant Enterobacteriaceae (MIC 4-16 µg/mL) infections (12 pneumonia, 12 urinary tract infection (UTI), two Bacteremia, and one skin/soft tissue infection) in which 74% harbored KPC. The isolates were polyclonal, 6 STs were identified and the colistin resistance was due to chromosome mutations. Eight patients with UTI received monotherapy, and combination therapy was given to 19 patients. Overall mortality was 37%. In vitro synergy using time-kill assay was observed in 14 of 19 (74%) isolates tested; the synergistic effect was observed for almost all isolates for the combination of three drugs: colistin, amikacin, and tigecycline. The Kaplan-Meier survival curve showed no significant difference comparing combination therapy with 2, 3, or more drugs and risk factors associated with death were dialysis and shock. These findings reinforce the fact that colistin in combination with other classes of drugs can be useful in treating infections caused by colistin-resistant CRE.
Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Métodos Terapéuticos y Terapias MTCI:
Plantas_medicinales
Asunto principal:
Amicacina
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Colistina
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Quimioterapia Combinada
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Enterobacteriaceae
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Infecciones por Enterobacteriaceae
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Minociclina
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Antibacterianos
Tipo de estudio:
Observational_studies
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Prognostic_studies
Idioma:
En
Revista:
Diagn Microbiol Infect Dis
Año:
2017
Tipo del documento:
Article
País de afiliación:
Brasil