Open AccessSynergistic activity of fosfomycin–meropenem and fosfomycin–colistin against carbapenem resistant Klebsiella pneumoniae: an in vitro evidence
Author(s) -
Yamuna Devi Bakthavatchalam,
Abirami Shankar,
Dhiviya Prabaa Muthuirulandi Sethuvel,
Kalaiarasi Asokan,
Kalaiarasi Kanthan,
Balaji Veeraraghavan
Publication year - 2020
Publication title -
future science oa
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.825
H-Index - 23
ISSN - 2056-5623
DOI - 10.2144/fsoa-2019-0074
Subject(s) - fosfomycin , colistin , meropenem , klebsiella pneumoniae , microbiology and biotechnology , carbapenem , biology , antibiotics , antibiotic resistance , escherichia coli , biochemistry , gene
Aim: To evaluate the antibacterial activity of fosfomycin–meropenem and fosfomycin–colistin combinations against carbapenem-resistant Klebsiella pneumoniae (CR-Kp). Methods: A total of 50 CR-Kp isolates recovered from blood cultures were included in this study. All the CR-Kp isolates were screened for the presence of carbapenem resistant genes bla IMP . bla VIM . bla NDM . bla OXA-48 like, bla KPC . bla GES .#x00A0;and bla SPM . Combination testing of fosfomycin–meropenem and fosfomycin–colistin were performed using time-kill assay. Results: Fosfomycin–meropenem combination showed synergy in 20% of the tested CR-Kp isolates. While, fosfomycin–colistin exhibited synergy against 16% of the isolates. A total of 68% (n = 34) of CR-Kp isolates were characterised as OXA-48-like producers and 22% (n = 11) as NDM producers. Synergistic activity of these combinations was observed against OXA-48, NDM and NDM + OXA-48 co-producers. Conclusion: Considerable synergistic antibacterial activity of fosfomycin–meropenem and fosfomycin–colistin was not observed against CR-Kp isolates. Therefore, these combinations may not be promising for infections associated with CR-Kp.