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JAC Advance Access originally published online on May 31, 2007
Journal of Antimicrobial Chemotherapy 2007 60(2):317-322; doi:10.1093/jac/dkm136
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

In vitro activities of carbapenem/sulbactam combination, colistin, colistin/rifampicin combination and tigecycline against carbapenem-resistant Acinetobacter baumannii

Joon Young Song1, Sae Yoon Kee1, In Sook Hwang2, Yu Bin Seo1, Hye Won Jeong1, Woo Joo Kim1 and Hee Jin Cheong1,*

1 Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea 2 Graduate School of Life Science and Biotechnology, Korea University, Seoul, Republic of Korea

Received 22 December 2006; returned 1 March 2007; revised 5 April 2007; accepted 11 April 2007

* Correspondence address. Division of Infectious Disease, Department of Internal Medicine, Korea University Guro Hospital, 97 Guro Dong-Gil, Guro Gu, 152-703 Seoul, Republic of Korea. Tel: +82-2-818-6649; Fax: +82-2-866-1643; E-mail: heejinmd{at}medimail.co.kr

Objectives: To determine the in vitro activities and interactions of imipenem, colistin and tigecycline with old antibacterial agents against carbapenem-resistant Acinetobacter baumannii.

Methods: Forty-three carbapenem-resistant A. baumannii isolates from the intensive care unit of a university hospital were collected and their MICs of imipenem, colistin and tigecycline were determined. With eight randomly selected carbapenem-resistant isolates, an in vitro time–kill study was performed for the evaluation of antibacterial activity of colistin, tigecycline, imipenem/sulbactam and colistin/rifampicin.

Results: The time–kill study of colistin demonstrated bactericidal activity against A. baumannii at concentrations of 4 x MIC and 8 x MIC, whereas tigecycline showed bacteriostatic activity at all concentrations. The combination regimens of imipenem/sulbactam and colistin/rifampicin were synergistic and bactericidal at 1 x MIC.

Conclusions: Imipenem/sulbactam combination, colistin and tigecycline showed good in vitro activities against carbapenem-resistant A. baumannii isolates. Even though colistin is bactericidal against carbapenem-resistant A. baumannii, the colistin/rifampicin combination is more warranted in order to be certain.

Keywords: A. baumannii , synergy , time–kill assay


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