scholarly journals In vitro effectiveness of the antibiotic lock technique (ALT) for the treatment of catheter-related infections by Pseudomonas aeruginosa and Klebsiella pneumoniae

2007 ◽  
Vol 60 (4) ◽  
pp. 782-787 ◽  
Author(s):  
M. Y. Lee ◽  
K. S. Ko ◽  
J.-H. Song ◽  
K. R. Peck
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Antibiotic Lock ◽  
Antibiotic Lock Technique

Activité antibactérienne de l’huile essentielle de Pelargonium x asperum et son potentiel synergique avec la nisine

2019 ◽  
Vol 17 (3) ◽  
pp. 140-148 ◽  
Author(s):  
A. Ouelhadj ◽  
L. Ait Salem ◽  
D. Djenane
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Nous Avons ◽  
Activité Antibactérienne

Ce travail vise l’étude de l’activité antibactérienne de l’huile essentielle (HE) de Pelargoniumx asperum et de la bactériocine, la nisine seul et en combinaison vis-à-vis de six bactéries dont quatre sont multirésistantes d’origine clinique. L’activité antibactérienne in vitro a été évaluée par la méthode de diffusion sur gélose. La concentration minimale inhibitrice (CMI) est aussi déterminée pour HE. Les résultats ont révélé une activité antibactérienne significative exercée par HE visà-vis de Staphylococcus aureus (ATCC 43300), Staphylococcus aureus et Escherichia coli avec des diamètres d’inhibition de 36,00 ; 22,50 et 40,00 mm, respectivement. Cependant, l’HE de Pelargonium asperum a montré une activité antibactérienne supérieure par rapport à la nisine. Les valeurs des CMI rapportées dans cette étude sont comprises entre 1,98–3,96 μl/ml. Les combinaisons réalisées entre HE et la nisine ont montré un effet additif vis-à-vis de Escherichia coli (ATCC 25922) avec (50 % HE Pelargonium asperum + 50 % nisine). Par contre, nous avons enregistré une synergie vis-à-vis de Klebsiella pneumoniae avec (75 % HE Pelargonium asperum + 25 % nisine) et contre Pseudomonas aeruginosa avec les trois combinaisons testées. Les résultats obtenus permettent de dire que l’HE de Pelargonium asperum possède une activité antibactérienne ainsi que sa combinaison avec la nisine pourrait représenter une bonne alternative pour la lutte contre l’antibiorésistance.

scholarly journals Efeito antimicrobiano do extrato de Cranberry sobre micro-organismos causadores de infecção urinária

2016 ◽  
Vol 11 (31) ◽  
pp. 113-122
Author(s):  
Carla Franco Porto Belmont Souza ◽  
Luiz Eduardo Souza da Silva Irineu ◽  
Renan Silva De Souza ◽  
Renato da Silva Teixeira ◽  
Ivina Sanches Pereira ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Enterococcus Faecalis ◽  
Proteus Mirabilis ◽  
Enterococcus Faecium ◽  
Vaccinium Macrocarpon ◽  
Mueller Hinton

A resistência microbiana tem se mostrado um problema de proporções mundiais, causando estado de morbidade e mortalidade em diversos pacientes. Em vista disso, tem crescido a busca por métodos alternativos naturais de profilaxia. A investigação clínica sugere que o Extrato de Cranberry está entre as melhores propostas de prevenção natural. O Cranberry (Vaccinium macrocarpon) é um fruto que tem crescido comercialmente pelo sabor e propriedades benéficas à saúde. Dentre as formas comercializadas estão: o suco, o chá e as cápsulas contendo o extrato seco. A ação desta planta está relacionada ao tratamento de doenças do trato urinário, por possuir substâncias que inibem a adesão bacteriana ao epitélio do trato urinário, dificultando sua proliferação e reprodução. Dentre todas as infecções relacionadas à assistência a saúde, a Infecção do Trato Urinário é a mais frequentemente associada a procedimentos invasivos. Se não for tratada, pode resultar em complicações como pielonefrite aguda, bacteremia e pionefrose. Portanto, cranberry pode ser uma nova alternativa para o combate das infecções uroepiteliais, por ser um produto natural de preço acessível, e com formas de comercialização diversificada, ao contrário dos antimicrobianos convencionais, que por sua vez são caros e podem acabar causando resistência nos micro-organismos. Este trabalho teve como objetivo avaliar in vitro a atividade antimicrobiana do extrato de Cranberry, adquirido em farmácia de manipulação, sobre 8 micro-organismos isolados de infecções urinárias. As cepas utilizadas, adquiridas da coleção da FIOCRUZ, foram: Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, Serratia marscecens, Staphylococcus aureus, Enterococcus faecalis e Enterococcus faecium. No estudo, foram utilizados o caldo Mueller Hinton (MH), Extrato de Cranberry e as bactérias patogênicas. O ensaio foi realizado em triplicata, com o uso de um controle de crescimento dos micro-organismos e o experimento para avaliação do crescimento bacteriano na presença do extrato. A turbidez foi medida com o auxílio de um espectrofotômetro, no comprimento de onda de 600 nm, antes e após 24 horas de incubação à 37 ºC. O procedimento forneceu a Densidade Ótica, do qual possibilitou a identificação da inibição microbiana. Para análise estatística foi utilizado o Teste t de Student. O Extrato de Cranberry apresentou atividade antimicrobiana sobre as bactérias Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Serratia marscecens e Enterococcus faecalis (p < 0,05), confirmando seu efeito benéfico em infecções urinárias. No entanto, não teve efeito inibitório significativo sobre Pseudomonas aeruginosa, Proteus mirabilis e Enterococcus faecium (p > 0,05).

scholarly journals Actividad antibacteriana in vitro de aceites esenciales de diferentes especies del género Citrus

2017 ◽  
Vol 46 (2) ◽  
Author(s):  
Miladys Esther Torrenegra Alarcón ◽  
Nerlis Paola Pájaro ◽  
Glicerio León Méndez
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Staphylococcus Epidermidis ◽  
E Coli

Se evaluó la actividad antibacteriana in vitro de aceites esenciales de diferentes especiesdel género Citrus frente a cepas ATCC de Staphylococcus aureus, Staphylococcus epidermidis,Klebsiella pneumoniae, Pseudomonas aeruginosa y Escherichia coli, determinandola concentración mínima inhibitoria (CMI) y la concentración mínima bactericida(CMB). Las bacterias se replicaron en medios de agar y caldos específicos. Se determinóel momento de máxima densidad óptica (DO620) para emplearlo como tiempode incubación; luego se hicieron pruebas de evaluación de sensibilidad con la exposiciónde las cepas a concentraciones a 1000 g/mL del extracto en caldo. Para solubilizarse empleó dimetilsulfóxido (DMSO) al 1%. Posteriormente, se le determinó laconcentración mínima inhibitoria mediante metodologías de microdilución en caldoy la concentración mínima bactericida. Encontrándose una actividad de los aceitesesenciales del género Citrus, con valores de CMI ≥ 600 mg/mL frente a S. aureus,S. epidermidis, K. pneumoniae, P. aeruginosa y E. coli. En función a los resultados obtenidos,se concluye que las diferentes especies del género Citrus son consideradas comopromisorias para el control del componente bacteriano.

scholarly journals Synthetic Antimicrobial Peptides Exhibit Two Different Binding Mechanisms to the Lipopolysaccharides Isolated from Pseudomonas aeruginosa and Klebsiella pneumoniae

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Hanbo Chai ◽  
William E. Allen ◽  
Rickey P. Hicks
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Antimicrobial Peptides ◽  
Inhibitory Activity ◽  
Binding Conformation ◽  
Cd Studies ◽  
Synthetic Antimicrobial Peptides ◽  
Activity Mechanism ◽  
Binding Mechanisms

Circular dichroism and 1H NMR were used to investigate the interactions of a series of synthetic antimicrobial peptides (AMPs) with lipopolysaccharides (LPS) isolated from Pseudomonas aeruginosa and Klebsiella pneumoniae. Previous CD studies with AMPs containing only three Tic-Oic dipeptide units do not exhibit helical characteristics upon interacting with small unilamellar vesicles (SUVs) consisting of LPS. Increasing the number of Tic-Oic dipeptide units to six resulted in five analogues with CD spectra that exhibited helical characteristics on binding to LPS SUVs. Spectroscopic and in vitro inhibitory data suggest that there are two possible helical conformations resulting from two different AMP-LPS binding mechanisms. Mechanism one involves a helical binding conformation where the AMP binds LPS very strongly and is not efficiently transported across the LPS bilayer resulting in the loss of inhibitory activity. Mechanism two involves a helical binding conformation where the AMP binds LPS very loosely and is efficiently transported across the LPS bilayer resulting in an increase in inhibitory activity. Mechanism three involves a nonhelical binding conformation where the AMP binds LPS very loosely and is efficiently transported across the LPS bilayer resulting in an increase in inhibitory activity.

scholarly journals Comparative Efficacies of Quinupristin-Dalfopristin, Linezolid, Vancomycin, and Ciprofloxacin in Treatment, Using the Antibiotic-Lock Technique, of Experimental Catheter-Related Infection Due to Staphylococcus aureus

2005 ◽  
Vol 49 (10) ◽  
pp. 4042-4045 ◽  
Author(s):  
Andrea Giacometti ◽  
Oscar Cirioni ◽  
Roberto Ghiselli ◽  
Fiorenza Orlando ◽  
Federico Mocchegiani ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Venous Catheter ◽  
Blood Cultures ◽  
Adherent Cell ◽  
Minimal Bactericidal Concentration ◽  
Biofilm Model ◽  
Isotonic Sodium Chloride ◽  
Antibiotic Lock ◽  
Antibiotic Lock Technique

ABSTRACT We performed in vitro studies to elucidate the bactericidal activity of the antibiotics in an adherent-cell biofilm model. Efficacy studies were performed in a staphylococcal central venous catheter (CVC) infection rat model. Silastic catheters were implanted into the superior cava. Via the CVC the rats were challenged with 1.0 × 106 CFU of a live Staphylococcus aureus strain. Twenty-four hours later, the antibiotic-lock technique was started. All animals were randomized to receive daily isotonic sodium chloride solution, quinupristin-dalfopristin (Q/D), linezolid, vancomycin, or ciprofloxacin at the minimal bactericidal concentration (MBC) and at 1,024 μg/ml in a volume of 0.1 ml that filled the CVC. The main outcome measures were MICs and MBCs for both planktonic and adherent cells, quantitative culture of the catheters and surrounding venous tissues, and quantitative peripheral blood cultures. The killing activities of all antibiotics against the adherent bacteria were at least fourfold lower than those against freely growing cells, with the exception of Q/D, which showed comparable activities against both adherent and planktonic organisms. Overall, Q/D at 1,024 μg/ml produced the greatest reduction in the number of cells recovered from the catheters, while at the same concentration, Q/D and vancomycin demonstrated higher activities than ciprofloxacin or linezolid in reducing the number of organisms recovered from the blood cultures. This study points out that treatment outcome of device-related infections cannot be predicted by the results of a standard susceptibility test such as the MIC. Our findings suggest that the clinically used antibiotics cannot eradicate the CVC infection through the antibiotic-lock technique, even at a concentration of 1,024 μg/ml.

scholarly journals Comparison of the Activity of a Human Simulated, High-Dose, Prolonged Infusion of Meropenem against Klebsiella pneumoniae Producing the KPC Carbapenemase versus That against Pseudomonas aeruginosa in an In Vitro Pharmacodynamic Model

2009 ◽  
Vol 54 (2) ◽  
pp. 804-810 ◽  
Author(s):  
Catharine C. Bulik ◽  
Henry Christensen ◽  
Peng Li ◽  
Christina A. Sutherland ◽  
David P. Nicolau ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
High Performance ◽  
Resistance Mechanisms ◽  
Free Drug ◽  
Pharmacodynamic Model ◽  
High Dose ◽  
Prolonged Infusion ◽  
Drug Concentrations

ABSTRACT We have previously demonstrated that a high-dose, prolonged-infusion meropenem regimen (2 g every 8 h [q8h]; 3-hour infusion) can achieve 40% free drug concentration above the MIC against Pseudomonas aeruginosa with MICs of ≤16 μg/ml. The objective of this experiment was to compare the efficacy of this high-dose, prolonged-infusion regimen against carbapenemase-producing Klebsiella pneumoniae isolates with the efficacy against P. aeruginosa isolates having similar meropenem MICs. An in vitro pharmacodynamic model was used to simulate human serum concentrations. Eleven genotypically confirmed K. pneumoniae carbapenemase (KPC)-producing isolates and six clinical P. aeruginosa isolates were tested for 24 h, and time-kill curves were constructed. High-performance liquid chromatography (HPLC) was used to verify meropenem concentrations in each experiment. Meropenem achieved a rapid ≥3 log CFU reduction against all KPC isolates within 6 h, followed by regrowth in all but two isolates. The targeted %fT>MIC (percent time that free drug concentrations remain above the MIC) exposure was achieved against both of these KPC isolates (100% fT>MIC versus MIC = 2 μg/ml, 75% fT>MIC versus MIC = 8 μg/ml). Against KPC isolates with MICs of 8 and 16 μg/ml that did regrow, actual meropenem exposures were significantly lower than targeted due to rapid in vitro hydrolysis, whereby targeted %fT>MIC was reduced with each subsequent dosing. In contrast, a ≥3 log CFU reduction was maintained over 24 h for all Pseudomonas isolates with meropenem MICs of 8 and 16 μg/ml. Although KPC and P. aeruginosa isolates may share similar meropenem MICs, the differing resistance mechanisms produce discordant responses to a high-dose, prolonged infusion of meropenem. Thus, predicting the efficacy of an antimicrobial regimen based on MIC may not be a valid assumption for KPC-producing organisms.

Antibiotic Lock Technique: A Review of the Literature

2005 ◽  
Vol 39 (2) ◽  
pp. 311-318 ◽  
Author(s):  
Marisel Segarra-Newnham ◽  
Ellen M Martin-Cooper
Keyword(s):  
Data Extraction ◽  
Success Rates ◽  
Coagulase Negative Staphylococci ◽  
Systemic Complications ◽  
Study Selection ◽  
Gram Negative Bacteremia ◽  
Antibiotic Lock ◽  
Therapy Success ◽  
Antibiotic Lock Technique

OBJECTIVE: To review the literature on the use of the antibiotic lock technique (ALT) as a treatment option for patients with highly needed catheters. DATA SOURCES: MEDLINE and International Pharmaceutical Abstracts were searched (1980–August 2004). Search terms included antibiotic lock, catheter infection, and topical treatment. STUDY SELECTION AND DATA EXTRACTION: Articles describing use of ALT in the treatment of catheter infections in humans and studies evaluating in vitro stability of antibiotics were included. DATA SYNTHESIS: ALT has been used in patients with highly needed catheters, usually for parenteral nutrition, cancer chemotherapy, or dialysis. Catheters are considered highly needed when removal is not feasible or desirable due to lack of alternative injection sites for required therapy. Success rates in saving the infected catheter have been variable and may depend on the infecting organism. In addition, there are conflicting data in terms of compatibility of antibiotics with heparin solutions. CONCLUSIONS: Consensus appears to be that the ALT can be tried for patients with highly needed catheters when infection with coagulase-negative staphylococci is documented and no systemic signs of sepsis, such as hypotension, are evident. Most of these patients are likely to need systemic therapy as well. Infection of the catheter associated with systemic gram-negative bacteremia or fungemia will most likely require removal of the catheter to prevent systemic complications. Additional research with the ALT is warranted given unanswered questions.

Phänotypische Antibiotikaresistenzen von Bakterienisolaten aus Zier-, Zoo- und falknerisch gehaltenen Greifvögeln

2020 ◽  
Vol 48 (04) ◽  
pp. 260-269
Author(s):  
Leonie Steger ◽  
Monika Rinder ◽  
Rüdiger Korbel
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Enterococcus Faecalis ◽  
Enterobacter Cloacae ◽  
Coli Isolate ◽  
Aureus Isolate ◽  
E Coli ◽  
Klinische Relevanz

Zusammenfassung Gegenstand und Ziel Die Prävalenz von antibiotikaresistenten Bakterien bei Zier-, Zoo- und falknerisch gehaltenen Greifvögeln ist noch weitgehend unbekannt. Daher sollten retrospektiv Antibiogramme schnellwachsender aerober Bakterienarten ausgewertet werden. Material und Methoden Im Auswertungszeitraum von 2007 bis 2016 standen 1036 Antibiogramme zur Verfügung. Die Bakterienisolate stammten vorzugsweise aus Süddeutschland und von 811 Vögeln aus 20 zoologischen Ordnungen (am häufigsten Papageienvögel [61,8 %] und Sperlingsvögel [14,5 %]) sowie aus Proben von klinischen Patienten und Sektionsmaterial. Die phänotypische In-vitro-Empfindlichkeit wurde mittels Plattendiffusionstest ermittelt. Ergebnisse Die meisten Antibiogramme lagen für E. coli (n = 386 Isolate) vor, gefolgt von Staphylococcus (S.). aureus (n = 150), Enterobacter cloacae (n = 122), Klebsiella pneumoniae (n = 86) und Pseudomonas aeruginosa (n = 64). Resistenzen gegen mindestens einen antibiotischen Wirkstoff zeigten 53,1 % der E. coli-Isolate, dabei am häufigsten gegen Doxycyclin (50,3 %) und Ampicillin (46,1 %). Bei 78,0 % der S. aureus-Isolate und bei 95,9 % der Enterococcus faecalis-Isolate wurden Resistenzen gegenüber mindestens einem Wirkstoff nachgewiesen. Multiresistenzen (Resistenz gegenüber ≥ 3 Antibiotikagruppen) traten bei 37,3 % der Isolate von S. aureus auf. Bei Isolaten von Zier- und Greifvögeln wurden höhere Resistenzraten festgestellt als bei Isolaten von Zoovögeln und bei Papageienvögeln höhere Resistenzraten als bei Sperlingsvögeln. Im Untersuchungszeitraum zeigte sich bei E. coli ein tendenzieller Anstieg der Resistenzrate für Fluorchinolone (Minimum von 0 % im Jahr 2013 und Maximum von 27,3 % im Jahr 2015) und bei S. aureus eine tendenzielle Abnahme der Resistenzraten für Tetrazykline (Maximum von 39,4 % im Jahr 2007 und Minimum von 0 % in den Jahren 2014 und 2015). Schlussfolgerung und klinische Relevanz Die Resistenzsituation von Bakterien aus Zier-, Zoo- und falknerisch gehaltenen Greifvögeln ist als problematisch zu bewerten und verdeutlicht die Wichtigkeit der Empfindlichkeitsprüfung für eine gewissenhafte Therapie. Im Fall einer Infektion mit S. aureus bei Zier-, Zoo- oder falknerisch gehaltenen Greifvögeln kann es zu einem Therapienotstand kommen.

scholarly journals Global trends of antimicrobial susceptibility of ceftaroline and ceftazidime-avibactam: a surveillance study from the ATLAS program (2012-2016)

2020 ◽  
Author(s):  
Hui Zhang ◽  
Yingchun Xu ◽  
Peiyao Jia ◽  
Ying Zhu ◽  
Ge Zhang ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
North America ◽  
Middle East ◽  
Klebsiella Pneumoniae ◽  
Antimicrobial Susceptibility ◽  
Asia Pacific ◽  
Global Trends ◽  
Specific Species

Abstract Background:This study reports the global trends of antimicrobial susceptibility toceftaroline and ceftazidime-avibactam using data from the Antimicrobial Testing Leadership And Surveillance (ATLAS)programbetween2012and2016.Methods:For the 2012-2016 ATLAS program, 205 medical centers located in Africa-Middle East (n=12), Asia-Pacific (n=32), Europe (n=94), Latin America (n=26), North America (n=31), and Oceania (n=10) consecutively collected the clinical isolates. Theminimum inhibitory concentrations (MICs) andin vitro susceptibilities toceftarolineandceftazidime-avibactam were assessed using the Clinical andLaboratory Standards Institute (CLSI) 2019and European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2019 guidelines.Results:Between 2012 and 2016, 176,345 isolates were collectedfrom around the globeand included in theanalysis.Regarding Gram-negative bacteria, ceftazidime-avibactam demonstrated high susceptibility (>90%) against EnterobacteriaceaeandPseudomonas aeruginosa, with increasedantimicrobial activity observed from the addition of avibactam (4 mg/L) to ceftazidime.Regarding Gram-positive bacteria, ceftaroline showed >90% susceptibility againstStaphylococcus aureus, Streptococcus pneumoniae, α-and β-hemolytic Streptococcus.The antimicrobial susceptibilitiestoceftaroline and ceftazidime-avibactam were mostly stable from 2012 to 2016, but the susceptibilitiestoceftazidime-avibactam to carbapenem-resistant (CR)Klebsiella pneumoniae(88.4% to 81.6%) and to CR-Pseudomonas aeruginosa(89.6% to 72.7%) decreased over time. In terms of regional difference, the susceptibilities of methicillin-resistant Staphylococcus aureusto ceftaroline in Asia and of CR-Klebsiella pneumoniaeto ceftazidime-avibactam in Asia/Africa-Middle East were lowercompared with other regions,while the susceptibility of CR-Pseudomonas aeruginosa to ceftazidime-avibactam in North America was higher.Conclusion: The addition of avibactam improves the activity of ceftazidime against EnterobacteriaceaeandPseudomonas aeruginosa. The global antimicrobial susceptibilitiestoceftaroline and ceftazidime-avibactam were, in general, stable from 2012 to 2016, but a marked reduction in the susceptibilities of specific species andCR-Pseudomonas aeruginosa toceftazidime-avibactam was observed.

scholarly journals HIỆU QUẢ PHỐI HỢP KHÁNG SINH IN VITRO TRÊN VI KHUẨN GRAM ÂM KHÁNG CARBAPENEM

2022 ◽  
Vol 508 (2) ◽  
Author(s):  
Ngô Hoàng Ngọc Thanh ◽  
Phạm Thái Bình ◽  
Cao Minh Nga
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Acinetobacter Baumannii

Đặt vấn đề: Theo Tổ chức Y tế thế giới (WHO), vi khuẩn (VK) Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae kháng carbapenem (APK-CR) là những vi khuẩn (VK) có mức cảnh báo cao nhất, cần ưu tiên phát triển các loại kháng sinh (KS) mới do tình trạng kháng thuốc đáng báo động [7]. Mục tiêu: Khảo sát MIC và hiệu quả phối hợp KS in vitro của meropenem (ME) - colistin (COL) và meropenem - ciprofloxacin (CIP) trên các chủng VK APK-CR. Phương pháp: Nghiên cứu mô tả cắt ngang. Các chủng APK-CR được phân lập tại Bệnh viện Đại học Y Dược TP. HCM từ tháng 12/2020 đến tháng 06/2021. Kết quả: Có 151 chủng gồm 51 chủng A. baumannii, 50 chủng P. aeruginosa và 50 chủng K. pneumoniae. MIC của ME và CIP trên các chủng APK-CR đều cao (chiếm 92-100%); có 6% chủng P. aeruginosa và 10% chủng K. pneumoniae là có MIC kháng COL. Hiệu quả hiệp đồng và cộng hợp trong phối hợp KS in vitro của ME-COL trên APK-CR có tỷ lệ lần lượt là 58,8% và 41,2%, 32% và 60%, 20% và 60%. Hiệu quả hiệp đồng và cộng hợp trong phối hợp KS in vitro của ME-CIP trên APK-CR có tỷ lệ lần lượt là 33,3% và 45,1%, 30% và 60%, 42% và 44%. Kết luận: APK-CR đề kháng với ME, CIP với tỷ lệ rất cao. Phối hợp ME-COL và ME-CIP trên APK-CR có kết quả hiệp đồng và cộng hợp làm giảm tỷ lệ đề kháng KS của APK-CR.

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