Combined therapeutic option for NDM-producing Serratia Marcescens – an in vitro study from clinical samples
Background: Treating NDM-producing bacteria poses a significant challenge, especially for those bacteria inherently resistant to polymyxin, such as Serratia marcescens, necessitating combined therapies. Objective: To assess in vitro the synergistic effect of different antimicrobial combinations agai...
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| Language: | English |
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Elsevier
2025-01-01
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| Series: | Brazilian Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867024007645 |
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| author | Balbina Chilombo Albano Leticia Ramos Dantas Gabriel Burato Ortis Paula Hansen Suss Felipe Francisco Tuon |
| author_facet | Balbina Chilombo Albano Leticia Ramos Dantas Gabriel Burato Ortis Paula Hansen Suss Felipe Francisco Tuon |
| author_sort | Balbina Chilombo Albano |
| collection | DOAJ |
| description | Background: Treating NDM-producing bacteria poses a significant challenge, especially for those bacteria inherently resistant to polymyxin, such as Serratia marcescens, necessitating combined therapies. Objective: To assess in vitro the synergistic effect of different antimicrobial combinations against NDM-producing S. marcescens. Methods: Four clinical isolates were tested with various antibiotic combinations: polymyxin, amikacin, meropenem, and aztreonam. Concentrations used were those maximized by pharmacokinetic and pharmacodynamic assessments. Synergy evaluation involved a static macrodilution test followed by a time-kill curve assay. Results: All four isolates demonstrated resistance according to CLSI and EUCAST standards for the tested antibiotics (polymyxin, amikacin, meropenem, and aztreonam). In the macrodilution synergy test, the combination of aztreonam and amikacin was active in 2 out of 4 isolates within 24 h, and polymyxin with meropenem in only one isolate, despite of intrinsic resistance to polymyxin. However, time-kill curve analysis revealed no synergism or additive effect for combinations with the tested antimicrobials. Conclusion: Combinations of polymyxin, meropenem, aztreonam, and amikacin at doses optimized by pharmacokinetic/pharmacodynamic were insufficient to demonstrate any synergism in NDM-producing S. marcescens isolates in time-kill curves. |
| format | Article |
| id | doaj-art-99eccf6c89374ad9820ab761799234a4 |
| institution | Kabale University |
| issn | 1413-8670 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj-art-99eccf6c89374ad9820ab761799234a42025-01-26T05:03:33ZengElsevierBrazilian Journal of Infectious Diseases1413-86702025-01-01291104481Combined therapeutic option for NDM-producing Serratia Marcescens – an in vitro study from clinical samplesBalbina Chilombo Albano0Leticia Ramos Dantas1Gabriel Burato Ortis2Paula Hansen Suss3Felipe Francisco Tuon4Pontifícia Universidade Católica do Paraná, Faculdade de Medicina, Laboratório de Doenças Infecciosas Emergentes, Curitiba, PR BrazilPontifícia Universidade Católica do Paraná, Faculdade de Medicina, Laboratório de Doenças Infecciosas Emergentes, Curitiba, PR BrazilPontifícia Universidade Católica do Paraná, Faculdade de Medicina, Laboratório de Doenças Infecciosas Emergentes, Curitiba, PR BrazilPontifícia Universidade Católica do Paraná, Faculdade de Medicina, Laboratório de Doenças Infecciosas Emergentes, Curitiba, PR BrazilCorresponding author.; Pontifícia Universidade Católica do Paraná, Faculdade de Medicina, Laboratório de Doenças Infecciosas Emergentes, Curitiba, PR BrazilBackground: Treating NDM-producing bacteria poses a significant challenge, especially for those bacteria inherently resistant to polymyxin, such as Serratia marcescens, necessitating combined therapies. Objective: To assess in vitro the synergistic effect of different antimicrobial combinations against NDM-producing S. marcescens. Methods: Four clinical isolates were tested with various antibiotic combinations: polymyxin, amikacin, meropenem, and aztreonam. Concentrations used were those maximized by pharmacokinetic and pharmacodynamic assessments. Synergy evaluation involved a static macrodilution test followed by a time-kill curve assay. Results: All four isolates demonstrated resistance according to CLSI and EUCAST standards for the tested antibiotics (polymyxin, amikacin, meropenem, and aztreonam). In the macrodilution synergy test, the combination of aztreonam and amikacin was active in 2 out of 4 isolates within 24 h, and polymyxin with meropenem in only one isolate, despite of intrinsic resistance to polymyxin. However, time-kill curve analysis revealed no synergism or additive effect for combinations with the tested antimicrobials. Conclusion: Combinations of polymyxin, meropenem, aztreonam, and amikacin at doses optimized by pharmacokinetic/pharmacodynamic were insufficient to demonstrate any synergism in NDM-producing S. marcescens isolates in time-kill curves.http://www.sciencedirect.com/science/article/pii/S1413867024007645SerratiaSynergismCarbapenemaseAztreonamPolymyxin |
| spellingShingle | Balbina Chilombo Albano Leticia Ramos Dantas Gabriel Burato Ortis Paula Hansen Suss Felipe Francisco Tuon Combined therapeutic option for NDM-producing Serratia Marcescens – an in vitro study from clinical samples Brazilian Journal of Infectious Diseases Serratia Synergism Carbapenemase Aztreonam Polymyxin |
| title | Combined therapeutic option for NDM-producing Serratia Marcescens – an in vitro study from clinical samples |
| title_full | Combined therapeutic option for NDM-producing Serratia Marcescens – an in vitro study from clinical samples |
| title_fullStr | Combined therapeutic option for NDM-producing Serratia Marcescens – an in vitro study from clinical samples |
| title_full_unstemmed | Combined therapeutic option for NDM-producing Serratia Marcescens – an in vitro study from clinical samples |
| title_short | Combined therapeutic option for NDM-producing Serratia Marcescens – an in vitro study from clinical samples |
| title_sort | combined therapeutic option for ndm producing serratia marcescens an in vitro study from clinical samples |
| topic | Serratia Synergism Carbapenemase Aztreonam Polymyxin |
| url | http://www.sciencedirect.com/science/article/pii/S1413867024007645 |
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