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Journal of Antimicrobial Chemotherapy (1995) 36, 619-629
© 1995 The British Society for Antimicrobial Chemotherapy

other

Bactericidal in-vitro activity of ßlactams and ßlactamase inhibitors, alone or associated, against clinical strains of Acinetobacter baumannii: effect of combination with aminoglycosides

M. L. Joly-Guilloua, D. Decréa, J. L. Hermanb, E. Bourdeliera and E. Bergogne-Bérézina

aDepartment of microbiology Bichat-Claude Bernard University, 46 rue Henri Huchard, 75018 Paris cedex 18 bHotel Dieu Hospital 75001, Paris, France

accepted 15 May 1995

Five Acinetobacter baumannii strains of various phenotypes were selected on the basis of the results of a national survey in France in 1991. ß-Lactamases in Acinetobacter isolates were characterized by isoelectrofocusing. We carried out a 24 h time-kill study to assess the bactericidal effect of antibiotic alone or in combination against A. baumannii strains. The initial inoculum was 106cfu/mL. Antibiotics were tested at MIC x 2 when an antibiotic was tested alone and at the MIC for each combination including ticarcillin, piperacillin, ceftazidime or imipenem with or without amikacin or netilmicin and/or ßj-lactamase inhibitors. Concentration of inhibitors were: 2 mg/L for clavulanic acid, 4 mg/L for tazobactam and 8 mg/L for sulbactam. Sulbactam and tazobactam showed an intrinsic in-vitro activity against strains susceptible to ticarcillin. A complete killing at 24 h was observed when ßlactams were combined with amikacin in comparison with antibiotics alone. Synergy was lost when the strain presented a low resistance level to ßlactams or aminoglycosides except for ticarcillin. Combinations of sulbactam with ticarcillin showed the best bactericidal activity against strains multiresistant to ßMactams.


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