Comparison of methods for the detection of in vitro synergy in multidrug-resistant gram-negative bacteria

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorGAUDERETO, Juliana Januario
dc.contributor.authorPERDIGAO NETO, Lauro Vieira
dc.contributor.authorLEITE, Gleice Cristina
dc.contributor.authorSANCHEZ, Evelyn
dc.contributor.authorMARTINS, Roberta Cristina Ruedas
dc.contributor.authorPRADO, Gladys Villas Boas
dc.contributor.authorROSSI, Flavia
dc.contributor.authorGUIMARAES, Thais
dc.contributor.authorLEVIN, Anna Sara
dc.contributor.authorCOSTA, Silvia Figueiredo
dc.date.accessioned2020-06-01T14:53:05Z
dc.date.available2020-06-01T14:53:05Z
dc.date.issued2020
dc.description.abstractBackground The use of combined antibiotic therapy has become an option for infections caused by multidrug-resistant (MDR) bacteria. The time-kill (TK) assay is considered the gold standard method for the evaluation of in vitro synergy, but it is a time-consuming and expensive method. The purpose of this study was to evaluate two methods for testing in vitro antimicrobial combinations: the disk diffusion method through disk approximation (DA) and the agar gradient diffusion method via the MIC:MIC ratio. The TK assay was included as the gold standard. MDR Gram-negative clinical isolates (n = 62; 28 Pseudomonas aeruginosa, 20 Acinetobacter baumannii, and 14 Serratia marcescens) were submitted to TK, DA, and MIC:MIC ratio synergy methods. Results Overall, the agreement between the DA and TK assays ranged from 20 to 93%. The isolates of A. baumannii showed variable results of synergism according to TK, and the calculated agreement was statistically significant in this species against fosfomycin with meropenem including colistin-resistant isolates. The MIC:MIC ratiometric agreed from 35 to 71% with TK assays. The kappa test showed good agreement for the combination of colistin with amikacin (K = 0.58; P = 0.04) among the colistin-resistant A. baumannii isolates. Conclusions The DA and MIC:MIC ratiometric methods are easier to perform and might be a more viable tool for clinical microbiology laboratories.eng
dc.description.indexMEDLINEeng
dc.description.sponsorshipUniversity of Sao Paulo, Brazil
dc.description.sponsorshipNational Council of Technological and Scientific Development (CNPQ), BrazilNational Council for Scientific and Technological Development (CNPq)
dc.description.sponsorshipCNPQNational Council for Scientific and Technological Development (CNPq)
dc.identifier.citationBMC MICROBIOLOGY, v.20, n.1, article ID 97, 7p, 2020
dc.identifier.doi10.1186/s12866-020-01756-0
dc.identifier.issn1471-2180
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/35980
dc.language.isoeng
dc.publisherBMCeng
dc.relation.ispartofBMC Microbiology
dc.rightsopenAccesseng
dc.rights.holderCopyright BMCeng
dc.subjectSynergyeng
dc.subjectTime-killeng
dc.subjectDisk approximationeng
dc.subjectMICeng
dc.subjectMIC ratioeng
dc.subjectGram-negativeeng
dc.subjectMultidrug-resistanteng
dc.subject.otherklebsiella-pneumoniaeeng
dc.subject.otheracinetobacter-baumanniieng
dc.subject.otherpolymyxin-beng
dc.subject.othercolistin-resistanteng
dc.subject.otherpseudomonas-aeruginosaeng
dc.subject.otherantimicrobial agentseng
dc.subject.otherbeta-lactamaseseng
dc.subject.otherrapid detectioneng
dc.subject.otherdisk diffusioneng
dc.subject.othercombinationeng
dc.subject.wosMicrobiologyeng
dc.titleComparison of methods for the detection of in vitro synergy in multidrug-resistant gram-negative bacteriaeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalLEITE, Gleice Cristina:Univ Sao Paulo, Fac Med, Inst Med Trop, Hosp Clin,LIM 49, Ave Doutor Eneas de Carvalho Aguiar 470, BR-05403000 Sao Paulo, SP, Brazil
hcfmusp.citation.scopus10
hcfmusp.contributor.author-fmusphcJULIANA JANUARIO GAUDERETO
hcfmusp.contributor.author-fmusphcLAURO VIEIRA PERDIGAO NETO
hcfmusp.contributor.author-fmusphcEVELYN PATRICIA SANCHEZ ESPINOZA
hcfmusp.contributor.author-fmusphcROBERTA CRISTINA RUEDAS MARTINS
hcfmusp.contributor.author-fmusphcGLADYS VILLAS BOAS DO PRADO MELO
hcfmusp.contributor.author-fmusphcFLAVIA ROSSI
hcfmusp.contributor.author-fmusphcTHAIS GUIMARAES
hcfmusp.contributor.author-fmusphcANNA SARA SHAFFERMAN LEVIN
hcfmusp.contributor.author-fmusphcSILVIA FIGUEIREDO COSTA
hcfmusp.description.articlenumber97
hcfmusp.description.issue1
hcfmusp.description.volume20
hcfmusp.origemWOS
hcfmusp.origem.pubmed32299353
hcfmusp.origem.scopus2-s2.0-85083632003
hcfmusp.origem.wosWOS:000528565300001
hcfmusp.publisher.cityLONDONeng
hcfmusp.publisher.countryENGLANDeng
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