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Activity of colistin in combination with tigecycline or rifampicin against multidrug-resistant Stenotrophomonas maltophilia

Betts, JW, Phee, LM, Woodford, N and Wareham, DW (2014) Activity of colistin in combination with tigecycline or rifampicin against multidrug-resistant Stenotrophomonas maltophilia European Journal of Clinical Microbiology and Infectious Diseases: an international journal on pathogenesis, diagnosis, epidemiology, therapy, and prevention of infectious diseases, 33. pp. 1565-1572.

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Abstract

The antimicrobial treatment of Stenotrophomonas maltophilia infections is complicated by intrinsic multidrug resistance and a lack of reliable susceptibility data. We assessed the activity of colistin (COL), rifampicin (RIF) and tigecycline (TGC) alone and in combination using a range of in vitro susceptibility testing methodologies and a simple invertebrate model of S. maltophilia infection (Galleria mellonella). Synergy [fractional inhibitory concentration indices (FICIs) ≤0.5] between COL and either RIF or TGC was observed against 92 % and 88 % of 25 S. maltophilia isolates, respectively, despite resistance to one or another of the single agents alone. In time-kill assays, COL combined with either RIF or TGC was superior to single agents, but only the COL/RIF regimen was reliably bactericidal. The in vitro findings correlated with treatment outcomes in G. mellonella, with heightened survival observed for larvae treated with COL/RIF or COL/TGC compared with COL, RIF or TGC alone. COL combined with RIF was the most effective combination overall in both in vitro and in vivo (p < 0.05) assays. Given the difficulty in selecting appropriate therapy for S. maltophilia infections, regimens consisting of COL combined with RIF or TGC could be considered for clinical use.

Item Type: Article
Authors :
NameEmailORCID
Betts, JWjono.betts@surrey.ac.ukUNSPECIFIED
Phee, LMUNSPECIFIEDUNSPECIFIED
Woodford, NUNSPECIFIEDUNSPECIFIED
Wareham, DWUNSPECIFIEDUNSPECIFIED
Date : 10 April 2014
Identification Number : 10.1007/s10096-014-2101-3
Depositing User : Symplectic Elements
Date Deposited : 17 May 2017 10:43
Last Modified : 17 May 2017 14:52
URI: http://epubs.surrey.ac.uk/id/eprint/828979

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