Combination antimicrobial susceptibility testing of Burkholderia cepacia complex

significance of species

Felicity K Abbott, Kathleen E N Milne, David A Stead, Ian M Gould

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The Burkholderia cepacia complex (Bcc) is notorious for the life-threatening pulmonary infections it causes in patients with cystic fibrosis. The multidrug-resistant nature of Bcc and differing infective Bcc species make the design of appropriate treatment regimens challenging. Previous synergy studies have failed to take account of the species of Bcc isolates. Etest methodology was used to facilitate minimum inhibitory concentration (MIC) and antimicrobial combination testing on 258 isolates of Bcc, identified to species level by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). The most active antimicrobials were trimethoprim/sulphamethoxazole, doxycycline and minocycline (52.5%, 46.4% and 45.9% of isolates susceptible, respectively). Synergy was observed in 9.2% of the 1799 combinations tested; the most common synergistic combinations were tobramycin + ceftazidime, meropenem + tobramycin and levofloxacin + piperacillin/tazobactam (35.4%, 32.3% and 22.2% synergy, respectively). Antimicrobial susceptibility analysis revealed differences between Burkholderia cenocepacia and Burkholderia multivorans. Disparity in clinical outcome during infection with these two micro-organisms necessitates further investigation into the clinical outcomes of treatment regimens in light of species identification and in vitro antimicrobial susceptibility studies.

Original languageEnglish
Pages (from-to)521-527
Number of pages7
JournalInternational Journal of Antimicrobial Agents
Volume48
Issue number5
Early online date12 Sep 2016
DOIs
Publication statusPublished - Nov 2016

Fingerprint

Burkholderia cepacia complex
Tobramycin
meropenem
Burkholderia cenocepacia
Disk Diffusion Antimicrobial Tests
Burkholderia
Sulfamethoxazole
Levofloxacin
Minocycline
Trimethoprim
Ceftazidime
Doxycycline
Microbial Sensitivity Tests
Infection
Cystic Fibrosis
Mass Spectrometry
Lasers
Lung

Keywords

  • Burkholderia cepacia complex
  • B. cenocepacia
  • B. multivorans
  • antimicrobial susceptibility testing
  • synergy testing
  • Etest

Cite this

Combination antimicrobial susceptibility testing of Burkholderia cepacia complex : significance of species. / Abbott, Felicity K; Milne, Kathleen E N; Stead, David A; Gould, Ian M.

In: International Journal of Antimicrobial Agents, Vol. 48, No. 5, 11.2016, p. 521-527.

Research output: Contribution to journalArticle

@article{1ba608deb2564c65950c684f8bf6fe2c,
title = "Combination antimicrobial susceptibility testing of Burkholderia cepacia complex: significance of species",
abstract = "The Burkholderia cepacia complex (Bcc) is notorious for the life-threatening pulmonary infections it causes in patients with cystic fibrosis. The multidrug-resistant nature of Bcc and differing infective Bcc species make the design of appropriate treatment regimens challenging. Previous synergy studies have failed to take account of the species of Bcc isolates. Etest methodology was used to facilitate minimum inhibitory concentration (MIC) and antimicrobial combination testing on 258 isolates of Bcc, identified to species level by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). The most active antimicrobials were trimethoprim/sulphamethoxazole, doxycycline and minocycline (52.5{\%}, 46.4{\%} and 45.9{\%} of isolates susceptible, respectively). Synergy was observed in 9.2{\%} of the 1799 combinations tested; the most common synergistic combinations were tobramycin + ceftazidime, meropenem + tobramycin and levofloxacin + piperacillin/tazobactam (35.4{\%}, 32.3{\%} and 22.2{\%} synergy, respectively). Antimicrobial susceptibility analysis revealed differences between Burkholderia cenocepacia and Burkholderia multivorans. Disparity in clinical outcome during infection with these two micro-organisms necessitates further investigation into the clinical outcomes of treatment regimens in light of species identification and in vitro antimicrobial susceptibility studies.",
keywords = "Burkholderia cepacia complex, B. cenocepacia, B. multivorans, antimicrobial susceptibility testing, synergy testing, Etest",
author = "Abbott, {Felicity K} and Milne, {Kathleen E N} and Stead, {David A} and Gould, {Ian M}",
note = "Funding: CFASS is funded by the National Services Division of the Common Services Agency of the Scottish Executive and is available for use by Scottish Adult CF centres. The MALDI-TOF/MS analysis was supported by a grant from the NHS Grampian Clinical Microbiology Fund (NHS Grampian Endowment Funds Registered Charity Number SC017296). Acknowledgements The authors thank the laboratories and clinicians who use the Cystic Fibrosis Antibiotic Susceptibility testing Service (CFASS) for their support.",
year = "2016",
month = "11",
doi = "10.1016/j.ijantimicag.2016.07.020",
language = "English",
volume = "48",
pages = "521--527",
journal = "International Journal of Antimicrobial Agents",
issn = "0924-8579",
publisher = "Elsevier Science B. V.",
number = "5",

}

TY - JOUR

T1 - Combination antimicrobial susceptibility testing of Burkholderia cepacia complex

T2 - significance of species

AU - Abbott, Felicity K

AU - Milne, Kathleen E N

AU - Stead, David A

AU - Gould, Ian M

N1 - Funding: CFASS is funded by the National Services Division of the Common Services Agency of the Scottish Executive and is available for use by Scottish Adult CF centres. The MALDI-TOF/MS analysis was supported by a grant from the NHS Grampian Clinical Microbiology Fund (NHS Grampian Endowment Funds Registered Charity Number SC017296). Acknowledgements The authors thank the laboratories and clinicians who use the Cystic Fibrosis Antibiotic Susceptibility testing Service (CFASS) for their support.

PY - 2016/11

Y1 - 2016/11

N2 - The Burkholderia cepacia complex (Bcc) is notorious for the life-threatening pulmonary infections it causes in patients with cystic fibrosis. The multidrug-resistant nature of Bcc and differing infective Bcc species make the design of appropriate treatment regimens challenging. Previous synergy studies have failed to take account of the species of Bcc isolates. Etest methodology was used to facilitate minimum inhibitory concentration (MIC) and antimicrobial combination testing on 258 isolates of Bcc, identified to species level by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). The most active antimicrobials were trimethoprim/sulphamethoxazole, doxycycline and minocycline (52.5%, 46.4% and 45.9% of isolates susceptible, respectively). Synergy was observed in 9.2% of the 1799 combinations tested; the most common synergistic combinations were tobramycin + ceftazidime, meropenem + tobramycin and levofloxacin + piperacillin/tazobactam (35.4%, 32.3% and 22.2% synergy, respectively). Antimicrobial susceptibility analysis revealed differences between Burkholderia cenocepacia and Burkholderia multivorans. Disparity in clinical outcome during infection with these two micro-organisms necessitates further investigation into the clinical outcomes of treatment regimens in light of species identification and in vitro antimicrobial susceptibility studies.

AB - The Burkholderia cepacia complex (Bcc) is notorious for the life-threatening pulmonary infections it causes in patients with cystic fibrosis. The multidrug-resistant nature of Bcc and differing infective Bcc species make the design of appropriate treatment regimens challenging. Previous synergy studies have failed to take account of the species of Bcc isolates. Etest methodology was used to facilitate minimum inhibitory concentration (MIC) and antimicrobial combination testing on 258 isolates of Bcc, identified to species level by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). The most active antimicrobials were trimethoprim/sulphamethoxazole, doxycycline and minocycline (52.5%, 46.4% and 45.9% of isolates susceptible, respectively). Synergy was observed in 9.2% of the 1799 combinations tested; the most common synergistic combinations were tobramycin + ceftazidime, meropenem + tobramycin and levofloxacin + piperacillin/tazobactam (35.4%, 32.3% and 22.2% synergy, respectively). Antimicrobial susceptibility analysis revealed differences between Burkholderia cenocepacia and Burkholderia multivorans. Disparity in clinical outcome during infection with these two micro-organisms necessitates further investigation into the clinical outcomes of treatment regimens in light of species identification and in vitro antimicrobial susceptibility studies.

KW - Burkholderia cepacia complex

KW - B. cenocepacia

KW - B. multivorans

KW - antimicrobial susceptibility testing

KW - synergy testing

KW - Etest

U2 - 10.1016/j.ijantimicag.2016.07.020

DO - 10.1016/j.ijantimicag.2016.07.020

M3 - Article

VL - 48

SP - 521

EP - 527

JO - International Journal of Antimicrobial Agents

JF - International Journal of Antimicrobial Agents

SN - 0924-8579

IS - 5

ER -