Meropenem/colistin synergy testing for multidrug-resistant Acinetobacter baumannii strains by a two-dimensional gradient technique applicable in routine microbiology

J Antimicrob Chemother. 2015 Jan;70(1):167-72. doi: 10.1093/jac/dku342. Epub 2014 Sep 19.

Abstract

Objectives: Precise assessment of potential therapeutic synergy, antagonism or indifference between antimicrobial agents currently depends on time-consuming and hard-to-standardize in vitro chequerboard titration methods. We here present a method based on a novel two-dimensional antibiotic gradient technique named Xact™.

Methods: We used a test comprising a combination of perpendicular gradients of meropenem and colistin in a single quadrant. We compared test outcomes with those obtained with classical chequerboard microbroth dilution testing in a study involving 27 unique strains of multidrug-resistant Acinetobacter baumannii from diverse origins.

Results: We were able to demonstrate 92% concordance between the new technology and classical chequerboard titration using the A. baumannii collection. Two strains could not be analysed by Xact™ due to their out-of-range MIC of meropenem (>128 mg/L).

Conclusions: The new test was shown to be diagnostically useful, easy to implement and less labour intensive than the classical method.

Keywords: antibiotic resistance; susceptibility testing; two-dimensional Etest.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acinetobacter baumannii / drug effects*
  • Anti-Bacterial Agents / pharmacology*
  • Colistin / pharmacology*
  • Drug Resistance, Multiple, Bacterial*
  • Drug Synergism*
  • Meropenem
  • Microbial Sensitivity Tests / methods*
  • Thienamycins / pharmacology*

Substances

  • Anti-Bacterial Agents
  • Thienamycins
  • Meropenem
  • Colistin