Synergistic Combinations and Repurposed Antibiotics Active against the Pandrug-Resistant Klebsiella pneumoniae Nevada Strain

In early 2017, the Centers for Disease Control and Prevention issued an alarming report describing a woman in Nevada who died in the setting of infection with a panresistant Klebsiella pneumoniae isolate that harbored an NDM-1 enzyme (AR-0636) and was colistin resistant as a result of inactivation of the mgrB regulator gene (1, 2). Our laboratory has previously identified colistin-containing combinations that demonstrated in vitro synergy against colistin-resistant, carbapenem-resistant Enterobacteriaceae (3). Here, we therefore tested the activity of 20 combinations, 18 of which contained colistin, against AR-0636 to assess whether they merit future investigation as treatment options for patients infected with otherwise-panresistant Enterobacteriaceae. Copyright © 2019 American Society for Microbiology. All Rights Reserved.