Content area
Full Text
Thanyaluck Siriyong. 1 Department of Microbiology and Excellence Research Laboratory on Natural Products, Faculty of Science and Natural Product Research Center of Excellence, Prince of Songkla University, Hat Yai, Thailand.
Sasitorn Chusri. 2 Faculty of Traditional Thai Medicine and Excellence Research Laboratory on Natural Products, Faculty of Science and Natural Product Research Center of Excellence, Prince of Songkla University, Hat Yai, Thailand.
Potjanee Srimanote. 3 Graduate Program, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand.
Varomyalin Tipmanee. 4 Department of Biomedical Sciences, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Supayang Piyawan Voravuthikunchai. 1 Department of Microbiology and Excellence Research Laboratory on Natural Products, Faculty of Science and Natural Product Research Center of Excellence, Prince of Songkla University, Hat Yai, Thailand.
Address correspondence to: Supayang Piyawan Voravuthikunchai, PhD, Department of Microbiology and Excellence Research Laboratory on Natural Products, Faculty of Science and Natural Product Research Center of Excellence, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand, E-mail: [email protected]
Introduction
Acinetobacter baumannii has emerged as an important opportunistic pathogen frequently associated with nosocomial outbreaks worldwide.17 Multidrug-resistant (MDR) A. baumannii has been implicated as the cause of serious infections such as ventilator-associated pneumonia, bloodstream infection, meningitis, urinary tract infection, and wound infection. During the past decade, antibiotic resistance among A. baumannii has substantially increased. Currently, infections with MDR A. baumannii greatly limit therapeutic options leading to an increase in morbidity and mortality.10,29
Carbapenems remain the antibiotics of choice for the treatment of A. baumannii infections. However, carbapenem-resistant A. baumannii is now increasingly reported worldwide.19 Colistin, an old antibiotic from the polymyxin group, has become the last resort for treatment of MDR A. baumannii. In addition, colistin demonstrates adverse effects regarding nephrotoxicity and neurotoxicity. Recently, colistin-resistant A. baumannii has already been reported. Therefore, combination therapy of colistin with other antibiotics might be an applicable alternative. Many in vitro, in vivo, and clinical studies have shown synergistic effects of colistin in combination with rifampicin for MDR or extensively drug-resistant (XDR) A. baumannii.4 In addition, a recent study confirmed the synergistic colistin/rifampicin combination against heteroresistant isolates and prevented the development of colistin-resistant mutants.32 However, moderate hepatic cytolysis has been noticed in clinical study.25
The search for new compounds with...