{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:04:48Z","timestamp":1790845488860,"version":"4.1.0"},"reference-count":25,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2013,8,1]],"date-time":"2013-08-01T00:00:00Z","timestamp":1375315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Infections caused by carbapenem-resistant KPC-producing\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Klebsiella pneumoniae<\/jats:named-content>\n            are responsible for high rates of mortality and represent a major therapeutic challenge, especially when the isolates are also resistant to colistin. We used the checkerboard method to evaluate the synergistic activity of 10 antibiotic combinations against 13 colistin-resistant KPC-producing\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">K. pneumoniae<\/jats:named-content>\n            isolates (colistin MIC range of 8 to 128 mg\/liter). Colistin plus rifampin was the only combination that demonstrated consistent synergistic bacteriostatic activity against 13\/13 strains tested, reducing the colistin MIC below the susceptibility breakpoint (MIC \u2264 2 mg\/liter) in 7\/13 strains at rifampin concentrations ranging from 4 to 16 mg\/liter. Bactericidal synergistic activity was also documented for 8\/13 tested strains. Other antimicrobial combinations with carbapenems, gentamicin, and tigecycline showed variously synergistic results. Colistin plus rifampin also exhibited bacteriostatic synergistic activity against 4\/4 colistin-susceptible KPC-producing\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">K. pneumoniae<\/jats:named-content>\n            isolates (colistin MIC range of 0.5 to 2 mg\/liter) and 4\/4 ertapenem-resistant extended-spectrum beta-lactamase (ESBL)-producing\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">K. pneumoniae<\/jats:named-content>\n            isolates (ertapenem MIC range of 16 to 32 mg\/liter). Collectively, our data suggest that colistin plus rifampin is the most consistently synergistic combination against KPC-producing\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">K. pneumoniae<\/jats:named-content>\n            isolates, including colistin-resistant strains. Colistin-rifampin combinations may have a role in the treatment of multidrug-resistant\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">K. pneumoniae<\/jats:named-content>\n            and may possibly slow the selection of heteroresistant subpopulations during colistin therapy.\n          <\/jats:p>","DOI":"10.1128\/aac.00179-13","type":"journal-article","created":{"date-parts":[[2013,6,11]],"date-time":"2013-06-11T04:02:11Z","timestamp":1370923331000},"page":"3990-3993","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":103,"title":["Synergistic Activity of Colistin plus Rifampin against Colistin-Resistant KPC-Producing Klebsiella pneumoniae"],"prefix":"10.1128","volume":"57","author":[{"given":"Carlo","family":"Tascini","sequence":"first","affiliation":[{"name":"U.O. Malattie Infettive, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Tagliaferri","sequence":"additional","affiliation":[{"name":"U.O. Malattie Infettive, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Giani","sequence":"additional","affiliation":[{"name":"Dipartimento di Biotecnologie Mediche, Universit\u00e0 di Siena, Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Leonildi","sequence":"additional","affiliation":[{"name":"U.O. Malattie Infettive, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Flammini","sequence":"additional","affiliation":[{"name":"U.O. Malattie Infettive, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Casini","sequence":"additional","affiliation":[{"name":"Dipartimento di Ricerca Traslazionale, Universit\u00e0 di Pisa, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell","family":"Lewis","sequence":"additional","affiliation":[{"name":"U.O. Malattie Infettive, Policlinico S'Orsola-Malpighi, Universit\u00e0 di Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Ferranti","sequence":"additional","affiliation":[{"name":"U.O. Malattie Infettive, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Maria","family":"Rossolini","sequence":"additional","affiliation":[{"name":"Dipartimento di Biotecnologie Mediche, Universit\u00e0 di Siena, Siena, Italy"},{"name":"Dipartimento di Medicina Sperimentale e Clinica, Sezione di Medicina Critica e Medicine Specialistiche, Universit\u00e0 di Firenze, Florence, Italy"},{"name":"S.O.D. Microbiologia e Virologia, Azienda Ospedaliera Universitaria Careggi, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Menichetti","sequence":"additional","affiliation":[{"name":"U.O. Malattie Infettive, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1710.110655"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.05035-11"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-010-0921-3"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr166"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq108"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis588"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.06268-11"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis969"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02301-09"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr007"},{"key":"e_1_3_2_12_2","volume-title":"Abstr. 51st Intersci. 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