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KMID : 0364820080440040339
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Korean Journal of Microbiology
2008 Volume.44 No. 4 p.339 ~ p.345
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Effect of Antibiotic Combination Therapy on Metallo-β-Lactamase Producing Imipenem Resistant Pseudomonas aeruginosa
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Hong Seung-Bok
Kim Hong-Chul
Lee Jang-Won
Son Seung-Yeol
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Abstract
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This study was to detect MBL (metallo-β-lactamase) among glucose non-fermenting Gram-negative bacilli isolated from clinical specimen and to search antimicrobial combination therapy against MBL producing Pseudomonas aeruginosa. Among fifty one isolates of Gram-negative bacilli with reduced imipenem susceptibility (MIC ≥8 μg/ml), nine isolates have shown positive results in MBL detection test. They were seven Achromobacter xylosoxidans subsp. xylosoxidans and two P. aeruginosa. The results from EDTA-DDST coincided with those of PCR and nucleotide sequence analysis which showed the presence of blaVIM-2. The combination of aztreonam (AZT) and piperacillin-tazobactam (TZP) or AZT and amikacin (AN) screened by one disk synergy test showed no synergistic effect. Triple antibiotic combination therapy with AZT, TZP and AN, however, was shown to be effective and the most synergistic after 8 hrs of exposure. This result strongly suggest that the triple combination therapy of AZT, TZP, and AN could be useful for the treatment of infection caused by MBL producing Gram-negative bacilli.
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KEYWORD
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combination therapy, MBL, P. aeruginosa
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