國家衛生研究院 NHRI:Item 3990099045/9684

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Title:	In vivo and in vitro efficacy of minocycline-based combination therapy for minocycline-resistant Acinetobacter baumannii
Authors:	Yang, YS;Lee, Y;Tseng, KC;Huang, WC;Chuang, MF;Kuo, SC;Yang Lauderdale, TL;Chen, TL
Contributors:	Division of Infectious Diseases
Abstract:	Minocycline-based combination therapy has been suggested as a possible choice for the treatment of minocycline-susceptible Acinetobacter baumannii but their use in minocycline-resistant ones is not well established. In this study, we compared the in vitro and in vivo efficacy of minocycline-based combination therapy (with colistin, cefoperazone/sulbactam or meropenem) to colistin in combination with meropenem for the treatment of minocycline-resistant A. baumannii. During 2006-2010, 191 (17.6%) of 1083 A. baumannii complex isolates not susceptible to minocycline from the Taiwan Surveillance of Antimicrobial Resistance program were collected. Four representative A. baumannii resistant to minocycline, amikacin, ampicillin/sulbactam, ceftazidime, ciprofloxacin, cefepime, gentamicin, imipenem, levofloxacin, meropenem, and piperacillin/tazobactam were selected based on their diversity in pulsotype, collection year, healthcare setting origin, and geographic area. All four isolates had tetB and overexpressed adeABC revealed by quantitative reverse transcription PCR. Among all minocycline-based regimens, only combination with colistin produced a fractional inhibitory concentration index comparable to meropenem combined with colistin. Minocycline (4 or 16 mug/mL) in combination with colistin (0.5 mug/mL) also synergistically killed minocycline-resistant isolates in time-kill studies. Minocycline (50 mg/kg) in combination with colistin (10 mg/kg) significantly improved the survival of mice and reduced the number of bacteria present in the lungs of mice compared to monotherapy. However, minocycline-based (16 mug/mL) therapy was not effective at reducing biofilm-associated bacteria at 24 or 48 h compared to colistin (0.5 mug/mL) and meropenem (8 mug/mL). The clinical use of minocycline in combination with colistin for the treatment of minocycline-resistant A. baumannii may warrant further investigation.
Date:	2016-07
Relation:	Antimicrobial Agents and Chemotherapy. 2016 Jul;60(7):4047-4054.
Link to:	http://dx.doi.org/10.1128/aac.02994-15
JIF/Ranking 2023:	http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0066-4804&DestApp=IC2JCR
Cited Times(WOS):	https://www.webofscience.com/wos/woscc/full-record/WOS:000378094400022
Cited Times(Scopus):	http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84977126028
Appears in Collections:	[Tsai-Ling Yang Lauderdale] Periodical Articles [Shu-Chen Kuo] Periodical Articles

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