In Vitro Combination Effects of Aztreonam and Aminoglycoside against Multidrug-Resistant Pseudomonas aeruginosa in Japan

Hideki Araoka; Masaru Baba; Kazuhiro Tateda; Yoshikazu Ishii; Toyoko Oguri; Katsuko Okuzumi; Tsuyoshi Oishi; Shinichiro Mori; Toshihiro Mitsuda; Kyoji Moriya; Yoshitaka Nakamori; Norio Ohmagari; Keizo Yamaguchi; Akiko Yoneyama; ABX Combination Therapy Study Group

doi:10.7883/yoken.65.84

Short Communications

In Vitro Combination Effects of Aztreonam and Aminoglycoside against Multidrug-Resistant Pseudomonas aeruginosa in Japan

Hideki Araoka, Masaru Baba, Kazuhiro Tateda, Yoshikazu Ishii, Toyoko Oguri, Katsuko Okuzumi, Tsuyoshi Oishi, Shinichiro Mori, Toshihiro Mitsuda, Kyoji Moriya, Yoshitaka Nakamori, Norio Ohmagari, Keizo Yamaguchi, Akiko Yoneyama, ABX Combination Therapy Study Group

Author information

Hideki Araoka
Department of Infectious Diseases, Toranomon Hospital, Japan
Masaru Baba
Department of Infectious Diseases, Toranomon Hospital, Japan
Kazuhiro Tateda
Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Japan
Yoshikazu Ishii
Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Japan
Toyoko Oguri
Laboratory Medicine, Kameda Medical Center, Japan
Katsuko Okuzumi
Department of Medical Safety Administration Division of Infection Control Dokkyo Medical University Hospital, Japan
Tsuyoshi Oishi
Department of Infectious Diseases, Tokyo Medical University Ibaraki Medical Center, Japan
Shinichiro Mori
Hematopoietic Stem Cell Transplantation Unit, National Cancer Center Hospital, Japan
Toshihiro Mitsuda
Department of Infection Prevention and Control, Yokohama City University Hospital, Japan
Kyoji Moriya
Department of Infection Control and Prevention, Graduate School of Medicine Faculty of Medicine, The University of Tokyo, Japan
Yoshitaka Nakamori
Department of Respiratory Diseases, Misyuku Hospital, Japan
Norio Ohmagari
Division of Infectious Diseases, Shizuoka Cancer Center, Japan
Keizo Yamaguchi
Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Japan
Akiko Yoneyama
Department of Infectious Diseases, Toranomon Hospital, Japan
ABX Combination Therapy Study Group

JOURNAL FREE ACCESS

2012 Volume 65 Issue 1 Pages 84-87

DOI https://doi.org/10.7883/yoken.65.84

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Abstract

The aim of this study was to evaluate the in vitro combination effects of aztreonam (AZT) and aminoglycosides against multidrug-resistant (MDR) Pseudomonas aeruginosa strains in Japan. We investigated 47 MDR P. aeruginosa strains collected from 8 facilities. We selected the aminoglycosides amikacin (AMK), gentamicin (GM), and arbekacin (ABK) to examine their effects when combined with AZT using the checkerboard method. Of the 47 MDR P. aeruginosa strains, 41 tested positive for metallo-β-lactamase (MBL). In all combinations, aminoglycosides decreased the minimum inhibitory concentrations of AZT in a dose-dependent manner, and there was no apparent antagonism. The combination effects were scored on a scale of 0 to 4, and statistical analysis was performed using the Wilcoxon signed-rank test. In all 47 strains, AZT + ABK (mean score, 2.02) had the highest score, followed by AZT + AMK (1.68) and AZT + GM (1.38) (ABK versus GM, P < 0.0001). In 41 MBL-positive strains, AZT + ABK (mean score, 2.05) had the highest score, followed by AZT + AMK (1.56) and AZT + GM (1.37) (ABK versus AMK, P = 0.02, and ABK versus GM, P < 0.0001). AZT + ABK was the most promising combination regimen against MDR P. aeruginosa strains; the other promising combinations were AZT + AMK and AZT + GM.

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