In Vitro Activity of Imipenem and Colistin against a Carbapenem-Resistant Klebsiella pneumoniae Isolate Coproducing SHV-31, CMY-2, and DHA-1

Biomed Res Int. 2015:2015:568079. doi: 10.1155/2015/568079. Epub 2015 May 3.

Abstract

We investigated the synergism of colistin and imipenem against a multidrug-resistant K. pneumoniae isolate which was recovered from a severe hip infection. PCR and DNA sequencing were used to characterize the outer membrane porin genes and the resistance genes mediating the common β-lactamases and carbapenemases. Synergism was evaluated by time-kill studies. The bla SHV-31, bla CMY-2, and bla DHA-1 were detected. Outer membrane porin genes analysis revealed loss of ompK36 and frame-shift mutation of ompK35. The common carbapenemase genes were not found. Time-kill studies demonstrated that a combination of 1x MIC of colistin (2 mg/L) and 1x MIC of imipenem (8 mg/L) was synergistic and bactericidal but with inoculum effect. Bactericidal activity without inoculum effect was observed by concentration of 2x MIC of colistin alone or plus 2x MIC of imipenem. In conclusion, colistin plus imipenem could be an alternative option to treat carbapenem-resistant K. pneumoniae infections.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacterial Proteins / genetics
  • Bacterial Proteins / isolation & purification*
  • Carbapenems / administration & dosage
  • Colistin / administration & dosage
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Drug Synergism
  • Hip / microbiology
  • Hip / pathology
  • Humans
  • Imipenem / administration & dosage
  • Klebsiella Infections / genetics
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / enzymology
  • Klebsiella pneumoniae / pathogenicity
  • Porins / genetics
  • beta-Lactamases / genetics
  • beta-Lactamases / isolation & purification*

Substances

  • Bacterial Proteins
  • Carbapenems
  • Porins
  • Imipenem
  • beta-lactamase CMY-2
  • beta-Lactamases
  • beta-lactamase DHA-1, Klebsiella pneumoniae
  • beta-lactamase SHV-31, Klebsiella pneumoniae
  • Colistin