{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T15:26:30Z","timestamp":1762356390605,"version":"build-2065373602"},"reference-count":39,"publisher":"Microbiology Society","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,5]]},"abstract":"<jats:p>\n                    <jats:bold>Introduction.<\/jats:bold>\n                    Carbapenem-resistant\n                    <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                    (CRAB) represents a critical healthcare threat with limited treatment options, particularly challenging in Southeast Asia where resistance rates exceed 65%.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Hypothesis\/Gap Statement.<\/jats:bold>\n                    Current synergy testing methods are labour-intensive and poorly standardized, limiting their clinical application. We hypothesize that synergistic interactions between antibiotics follow predictable mathematical patterns derivable from separate MIC determinations for each antibiotic.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Aim.<\/jats:bold>\n                    To evaluate the efficacy of colistin-meropenem-ampicillin\/sulbactam combinations at standard dosages and develop a predictive mathematical model for synergistic interactions against CRAB.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methodology.<\/jats:bold>\n                    A cross-sectional study was conducted using 61 CRAB clinical isolates from a Vietnamese tertiary hospital. MICs were determined using broth microdilution, and synergy was assessed via checkerboard assays. Mathematical models were developed to predict fractional inhibitory concentration (FIC) values from separate MIC determinations for each antibiotic.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results.<\/jats:bold>\n                    All isolates demonstrated high-level meropenem resistance (MICs 32-\u2265128\u2009\u00b5g\u2009ml\n                    <jats:sup>\u22121<\/jats:sup>\n                    ) and ampicillin\/sulbactam resistance (98.4% with MICs\u226564\/32\u2009\u00b5g\u2009ml\n                    <jats:sup>\u22121<\/jats:sup>\n                    ) but remained intermediate to colistin (MICs 0.0625\u20130.25\u2009\u00b5g\u2009ml\n                    <jats:sup>\u22121<\/jats:sup>\n                    ). The triple combination achieved 100% synergy at standard ampicillin\/sulbactam doses (8\/4\u2009\u00b5g\u2009ml\n                    <jats:sup>\u22121<\/jats:sup>\n                    ). Our log-transformed power model accurately predicted synergistic interactions (\n                    <jats:italic>R<\/jats:italic>\n                    \u00b2=0.928) using the equation log(FIC) = \u22122.52+(\u22121.02) \u00d7 1\/\u221aMero+0.43\u00d71\/\u221aCol+4.32\u00d71\/\u221aAs.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion.<\/jats:bold>\n                    The triple combination achieves universal synergy at standard dosages, potentially reducing toxicity risks. Our mathematical model enables rapid prediction of effective combinations from routine susceptibility tests, offering a transformative approach to optimizing therapy against multidrug-resistant pathogens.\n                  <\/jats:p>","DOI":"10.1099\/jmm.0.002086","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T15:17:35Z","timestamp":1762355855000},"source":"Crossref","is-referenced-by-count":0,"title":["Mathematical modelling of synergistic triple-antibiotic therapy against carbapenem-resistant Acinetobacter baumannii at clinically achievable concentrations"],"prefix":"10.1099","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9868-3430","authenticated-orcid":false,"given":"Tuan","family":"Huynh","sequence":"first","affiliation":[{"name":"Department of Microbiology, University Medical Center, 215 Hong Bang Street, Ward Cho Lon, Ho Chi Minh City, Vietnam"},{"name":"Department of Infection Control, University Medical Center, 215 Hong Bang Street, Ward Cho Lon, Ho Chi Minh City, Vietnam"},{"name":"Department of Microbiology and Parasitology, University of Medicine and Pharmacy, 217 Hong Bang Street, Ward Cho Lon, Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5878-9278","authenticated-orcid":false,"given":"Thanh","family":"Lam","sequence":"additional","affiliation":[{"name":"Faculty of Medical Technology, Van Lang University, 69\/68 Dang Thuy Tram Street, Ward Binh Loi Trung, Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1606-4067","authenticated-orcid":false,"given":"Ngan","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Parasitology, University of Medicine and Pharmacy, 217 Hong Bang Street, Ward Cho Lon, Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5365-5678","authenticated-orcid":false,"given":"Loan","family":"Luong","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University Medical Center, 215 Hong Bang Street, Ward Cho Lon, Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6542-6147","authenticated-orcid":false,"given":"My Dung","family":"Jusselme","sequence":"additional","affiliation":[{"name":"LEESU, Univ Paris Est Creteil, ENPC, Institut Polytechnique de Paris, Creteil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"345","reference":[{"key":"R1","article-title":"Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development","year":"2017"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201102-0349OC"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01520-13"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2018.58"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2012.04.320"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.076646-0"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-021-00937-4"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2023.04.007"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae403"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.04808-14"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2008.04.002"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1002\/prp2.746"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00850-10"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.2217\/fmb.13.39"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01268-16"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1128\/9781555817435"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-003-0962-y"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"R19","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing. 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