Abstract：
:Use of rifampicin (RIF) in combination with colistin (COL) has been proposed for the treatment of multidrug-resistant Acinetobacter baumannii infections owing to in vitro synergism. The aim of the present study was to evaluate the molecular epidemiology and mechanisms of RIF resistance in 57 clinical isolates of A. baumannii in two tertiary care hospitals in Naples (Italy) from 2006 to 2010. Amongst the collection, 36 isolates showed high RIF minimum inhibitory concentrations (MICs) (256 mg/L to ≥512 mg/L), 16 showed intermediate MICs (8-16 mg/L) and 5 had low MICs (4 mg/L). Of the 36 isolates with elevated RIF MICs, 35 were assigned to sequence type ST2 and 1 to ST78. Amongst the 57 isolates, 35 carried at least one mutation in rpoB, including H535L in 9 isolates and double mutations D525N and P544L in 7 isolates, whilst 22 showed no rpoB mutations. Treatment with the efflux pump inhibitor phenyl-arginine-β-naphthylamide (PAβN) of resistant isolates with no mutations in rpoB and different RIF MICs reduced the MIC by >10-fold and restored the synergism between RIF and COL in time-kill studies, whilst it had no effect on strains carrying rpoB mutations. In conclusion, the emergence of elevated RIF MICs in A. baumannii isolates from our geographical area was mostly caused by mutations in rpoB; low to intermediate RIF MICs were also caused by altered membrane permeability to the drug. The phenomenon was contributed by the selection of two prevalent clones both assigned to ST2 genotype. These data may have implications for the correct identification of cases with A. baumannii infection that would not benefit from addition of RIF to COL.
journal_name
Int J Antimicrob Agentsjournal_title
International journal of antimicrobial agentsauthors
Giannouli M,Di Popolo A,Durante-Mangoni E,Bernardo M,Cuccurullo S,Amato G,Tripodi MF,Triassi M,Utili R,Zarrilli Rdoi
10.1016/j.ijantimicag.2011.09.016subject
Has Abstractpub_date
2012-01-01 00:00:00pages
58-63issue
1eissn
0924-8579issn
1872-7913pii
S0924-8579(11)00389-Xjournal_volume
39pub_type
杂志文章abstract：:Seventy-three Salmonella isolates classified as ciprofloxacin susceptible when using the criteria of the National Committee for Clinical Laboratory Standards were studied for nalidixic acid (NA) resistance. The aim of the study was to determine the predictive value of nalidixic acid resistance in screening for decreas...
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