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JAC Advance Access published online on May 31, 2007
Journal of Antimicrobial Chemotherapy, 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 4x MIC and 8x MIC, whereas tigecycline showed bacteriostatic activity at all concentrations. The combination regimens of imipenem/sulbactam and colistin/rifampicin were synergistic and bactericidal at 1x 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.

Key Words: A. baumannii , synergy , time–kill assay


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