Antagonistic effect between tigecycline and meropenem: successful management of KPC-producing Klebsiella pneumoniae infection
- 13 Downloads
A woman infected by carbapenem-resistant Klebsiella pneumoniae is reported in this study.
Tigecycline and meropenem combination was used, and indeed, in vitro checkerboard synergy test confirmed the antagonism between the two antibiotics. Thus, meropenem was ceased and single high-dose tigecycline was successful against the infection. Subsequent experiments showed that the isolates of the KPC-2-producing K. pneumoniae ST11 clone caused the infection.
Therefore, tigecycline and meropenem combination should be used with caution.
KeywordsCarbapenem-resistance KPC-2-producing Klebsiella pneumoniae Tigecycline Meropenem Antagonistic effect
This study was supported by the following fundings: National Key Research and Development Program of China (No. 2016YFC1201603); National Natural Science Foundation of China (No. 81741098); Zhejiang Provincial Natural Science Foundation of China (No. LY17H190003).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This is a research involving a human participant.
The patient provided written informed consent to publish the clinical record.
- 6.Chinese XDRCWG, Guan X, He L, Hu B, Hu J, Huang X, et al. Laboratory diagnosis, clinical management and infection control of the infections caused by extensively drug-resistant Gram-negative bacilli: a Chinese consensus statement. Clin Microbiol Infect. 2016;22(Suppl 1):15–25.Google Scholar
- 8.Hu L, Liu Y, Deng L, Zhong Q, Hang Y, Wang Z, et al. Outbreak by ventilator-associated ST11 K. pneumoniae with co-production of CTX-M-24 and KPC-2 in a SICU of a tertiary teaching hospital in central China. Front Microbiol. 2016;7:1190.Google Scholar
- 9.Lubbert C, Baars C, Dayakar A, Lippmann N, Rodloff AC, Kinzig M, et al. Environmental pollution with antimicrobial agents from bulk drug manufacturing industries in Hyderabad, South India, is associated with dissemination of extended-spectrum beta-lactamase and carbapenemase-producing pathogens. Infection. 2017;45:479–91.CrossRefGoogle Scholar
- 10.Michail G, Labrou M, Pitiriga V, Manousaka S, Sakellaridis N, Tsakris A, et al. Activity of tigecycline in combination with colistin, meropenem, rifampin, or gentamicin against KPC-producing Enterobacteriaceae in a murine thigh infection model. Antimicrob Agents Chemother. 2013;57:6028–33.CrossRefGoogle Scholar
- 13.Pournaras S, Vrioni G, Neou E, Dendrinos J, Dimitroulia E, Poulou A, et al. Activity of tigecycline alone and in combination with colistin and meropenem against Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae strains by time-kill assay. Int J Antimicrob Agents. 2011;37:244–7.CrossRefGoogle Scholar