scholarly journals Microorganisms Resistant to Antimicrobials in Wild Canarian Egyptian Vultures (Neophron percnopterus majorensis)

Animals ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 970
Author(s):  
Alejandro Suárez-Pérez ◽  
Juan Alberto Corbera ◽  
Margarita González-Martín ◽  
José Antonio Donázar ◽  
Rubén Sebastián Rosales ◽  
...  
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Human Population ◽  
Resistant Bacteria ◽  
Livestock Waste ◽  
Antimicrobial Drugs ◽  
E Coli ◽  
Bird Of Prey ◽  
Neophron Percnopterus ◽  
Low Levels

Due to their predatory habits, raptors may serve as indicators of the presence of antimicrobial-resistant bacteria in the environment, but they also represent a public health risk for livestock and humans because they can act as reservoirs, sources and spreaders of these bacteria. Our objective was to determine the presence of antimicrobial-resistant bacteria in cloacal samples of Canarian Egyptian vultures (Neophron percnopterus majorensis), an endemic bird of prey. One hundred and forty-two cloacal swabs were obtained; Escherichia coli was isolated from 80.28% and Salmonella from 6.3% of these samples. Low levels of susceptibility to ampicillin, tetracycline and trimethoprim/sulfamethoxazole were found. About 20% of the isolates were resistant or presented intermediate susceptibility to fluoroquinolones. Surprisingly, we found isolates resistant to imipenem (6.96%). Isolates from chicks were more susceptible to antimicrobial drugs than adult and immature birds. About 50% of E. coli isolates were resistant to ampicillin, tetracycline and trimethoprim/sulfamethoxazole, and about 20% to piperacillin, enrofloxacin and marbofloxacin. High percentages of isolates of Salmonella were found to be resistant to cephalexin (88%) and aminoglycosides (greater than 77%). Our results support the idea that raptors could act as reservoirs of Salmonella and antimicrobial-resistant bacteria, posing a risk not only to wildlife but also to livestock and the human population, thus reinforcing the need to minimize the exposure of wildlife to antimicrobial agent through human and livestock waste.

scholarly journals Extended-spectrum beta-lactamase and ampicillin Class C beta lactamase-producing Escherichia coli from food animals: A review

2019 ◽  
pp. 65-75 ◽  
Author(s):  
Asinamai Athliamai Bitrus ◽  
Peter Anjili Mshelia ◽  
Iliya Dauda Kwoji ◽  
Mohammed Dauda Goni ◽  
Saleh Mohammed Jajere
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Health Concern ◽  
Resistant Bacteria ◽  
Beta Lactamase ◽  
Care Providers ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Class C

Antimicrobial resistance has gained global notoriety due to its public health concern, the emergence of multiple drug-resistant bacteria, and lack of new antimicrobials. Extended-spectrum beta-lactamase (ESBL)/ampicillin Class C (AmpC)- producing Escherichia coli and other zoonotic pathogens can be transmitted to humans from animals either through the food chain, direct contact or contamination of shared environments. There is a surge in the rate of resistance to medically important antibiotics such as carbapenem, ESBL, aminoglycosides, and fluoroquinolones among bacteria of zoonotic importance. Factors that may facilitate the occurrence, persistence and dissemination of ESBL/AmpC-Producing E. coli in humans and animal includes; 1). o ral administration of antimicrobials to humans primarily (by physician and health care providers) and secondarily to animals, 2). importation of parent stock and day-old chickens, 3). farm management practice and lack of water acidification in poultry, 4). contamination of feed, water and environment, 5). contamination of plants with feces of animals. Understanding these key factors will help reduce the level of resistance, thereby boosting the therapeutic effectiveness of antimicrobial agents in the treatment of animal and human infections. This review highlights the occurrence, risk factors, and public health importance of ESBL/AmpC-beta-lactamase producing E. coli isolated from livestock.

scholarly journals Detection of Integrase Gene inE. coliIsolated from Pigs at Different Stages of Production System

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Eulalia de la Torre ◽  
Rocío Colello ◽  
Nora Lía Padola ◽  
Analía Etcheverría ◽  
Edgardo Rodríguez ◽  
...  
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Production System ◽  
Environmental Samples ◽  
Resistant Bacteria ◽  
Chain Reaction ◽  
Integrase Gene ◽  
E Coli ◽  
Genetic Elements ◽  
Polymerase Chain

Integrons are one of the genetic elements involved in the acquisition of antibiotic resistance. The aim of the present research is to investigate the presence of integrons in commensalEscherichia coli(E. coli) strains, isolated from pigs at different stages of production system and from the environment in an Argentinian farm. Five sows postpartum and five randomly chosen piglets from each litter were sampled by rectal swabs. They were sampled again at day 21 and at day 70. Environmental samples from the farm were also obtained.E. colicontaining any integron class or combination of both integrons was detected by polymerase chain reaction in 100% of sows and in piglets at different stages of production: farrowing pen stage 68.1%;, weaning 60%, and growing/finishing 85.8%, showing an increase along the production system. From environmental samples 78.4% ofE. colicontaining any integron class was detected. We conclude that animals and farm environment can act as reservoirs for potential spread of resistant bacteria by means of mobile genetic elements as integrons, which has a major impact on production of food animals and that can reach man through the food chain, constituting a problem for public health.

scholarly journals Sources of Variation in the Ampicillin-Resistant Escherichia coli Concentration in the Feces of Organic Broiler Chickens

2006 ◽  
Vol 73 (1) ◽  
pp. 203-210 ◽  
Author(s):  
E. J. Pleydell ◽  
P. E. Brown ◽  
M. J. Woodward ◽  
R. H. Davies ◽  
N. P. French
Keyword(s):  
Escherichia Coli ◽  
Repeated Measures ◽  
Fixed Effects ◽  
Broiler Chickens ◽  
Resistant Bacteria ◽  
Published Data ◽  
Human Populations ◽  
Antimicrobial Drugs ◽  
E Coli ◽  
The Individual

ABSTRACT Currently, there are limited published data for the population dynamics of antimicrobial-resistant commensal bacteria. This study was designed to evaluate both the proportions of the Escherichia coli populations that are resistant to ampicillin at the level of the individual chicken on commercial broiler farms and the feasibility of obtaining repeated measures of fecal E. coli concentrations. Short-term temporal variation in the concentration of fecal E. coli was investigated, and a preliminary assessment was made of potential factors involved in the shedding of high numbers of ampicillin-resistant E. coli by growing birds in the absence of the use of antimicrobial drugs. Multilevel linear regression modeling revealed that the largest component of random variation in log-transformed fecal E. coli concentrations was seen between sampling occasions for individual birds. The incorporation of fixed effects into the model demonstrated that the older, heavier birds in the study were significantly more likely (P = 0.0003) to shed higher numbers of ampicillin-resistant E. coli. This association between increasing weight and high shedding was not seen for the total fecal E. coli population (P = 0.71). This implies that, in the absence of the administration of antimicrobial drugs, the proportion of fecal E. coli that was resistant to ampicillin increased as the birds grew. This study has shown that it is possible to collect quantitative microbiological data on broiler farms and that such data could make valuable contributions to risk assessments concerning the transfer of resistant bacteria between animal and human populations.

scholarly journals Poultry Litter Contamination by Escherichia coli Resistant to Critically Important Antimicrobials for Human and Animal Use and Risk for Public Health in Cameroon

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 402
Author(s):  
Frédéric Moffo ◽  
Mohamed Moctar Mouliom Mouiche ◽  
Hervé Kapnang Djomgang ◽  
Patchely Tombe ◽  
Abel Wade ◽  
...  
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Antimicrobial Agents ◽  
Poultry Litter ◽  
Farm Animals ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Multivariable Logistic Regression Analysis ◽  
E Coli ◽  
Poultry Farming

Residues of antimicrobials used in farm can exert selective pressure and accelerate the occurrence of multidrug resistant bacteria in litter. This study aimed to investigate the resistance profile of Escherichia coli isolated from poultry litter. A total of 101 E. coli strains was isolated from 229 litter samples collected and stored for two months in the laboratory at room temperature. Antimicrobial susceptibility testing was performed using the disk diffusion method. An overall resistance prevalence of 58.4% (95% CI: 48.8–68.0) was obtained with 59 E. coli strains resistant to various antimicrobial agents. High levels of resistance were observed with ciprofloxacin (21/59: 36%), imipenem (27/59: 45%), norfloxacin (44/59: 74%), ceftriaxone (44/59: 74%), and levofloxacin (44/59: 75%). These antimicrobials classified under the Watch group by WHO are indicators of the high AMR risk to public health in Cameroon. Multivariable logistic regression analysis revealed that a greater probability of high level of E. coli multidrug resistance was associated with lack of training in poultry farming (OR = 0.13, p = 0.01), less experience in poultry farming (OR = 11.66 p = 0.04), and the high frequency of digestive tract disease (OR = 0.10; p = 0.001). This study revealed that poultry litter constitutes a potential source of dissemination of resistant germs from farm animals to the environment and humans.

scholarly journals Proximity to human settlement is directly related to carriage of critically important antimicrobial-resistant Escherichia coli and Klebsiella pneumoniae in Silver Gulls

2021 ◽  
Author(s):  
Shewli Mukerji ◽  
Shafi Sahibzada ◽  
Rebecca Abraham ◽  
Marc Stegger ◽  
David Jordan ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Urban Areas ◽  
Human Population ◽  
Resistant Bacteria ◽  
Human Populations ◽  
E Coli ◽  
Remote Sites ◽  
High Level ◽  
The Relationship

AbstractHuman population and activities play an important role in dissemination of antimicrobial resistant bacteria. This study investigated the relationship between carriage rates of critically important antimicrobial-resistant (CIA-R) Escherichia coli and Klebsiella pneumoniae by Silver Gulls and their proximity to human populations. Faecal swabs (n=229) were collected from Silver Gulls across 10 southern coastline locations in Western Australia (WA). The sampling locations included main town centres and remote areas. Fluoroquinolone and extended-spectrum cephalosporin-resistant E. coli and K. pneumoniae were isolated and tested for antimicrobial sensitivity. Genome sequencing was performed to validate phenotypic resistance profiles and determine the molecular characteristics of strains. CIA-R E. coli and K. pneumoniae were detected in 69 (30.1%) and 20 (8.73%) of the faecal swabs respectively. Two large urban locations tested positive for CIA-R E. coli (frequency ranging from 34.3%-84.3%), and/or for CIA-R K. pneumoniae (frequency ranging from 12.5%-50.0%). A small number of CIA-R E. coli (3/31, 9.7%) were identified at a small tourist town, but no CIA-R bacteria were recovered from gulls at remote sites. Commonly detected E. coli sequence types (STs) included ST131 (12.5%) and ST1193 (10.0%), and five K. pneumoniae STs were found. Resistance genes including blaCTX-M-3, blaCTX-M-15 and blaCTX-M-27 were identified in both bacterial species. High-level colonisation of CIA-R E. coli and K. pneumoniae in Silver Gulls in and around urban areas compared to remote locations substantiates that anthropogenic activities are strongly associated with acquisition of resistant bacteria by gulls.ImportanceHumans play an important role in dissemination of antimicrobial resistant bacteria. This study investigated the relationship between carriage rates of resistant bacterial pathogens (Escherichia coli and Klebsiella pneumoniae) among Silver Gulls and their proximity to human populations. The frequency of resistant E. coli carriage was high (ranging from 34.3 – 84.3%) in the samples collected from areas with high human population density while resistant K. pneumoniae frequencies at these sites varied from 0 to 50%. However, resistant E. coli and K. pneumoniae were not recovered from any of the remote sites that did not have a permanent human population. This study, conducted across a large stretch of the southwestern Australian coastline, indicated that seagulls act as vectors in carrying and disseminating antimicrobial resistant bacteria, including clinically significant strains. High-level colonisation of resistant E. coli and K. pneumoniae in Silver Gulls in and around urban areas compared to remote locations substantiates that human activities are strongly associated with acquisition of resistant bacteria by Silver gulls.

scholarly journals Detection of Genotipically Related Multi-resistant Escherichia coli Isolates in Pig Feces and Carcasses

2018 ◽  
Vol 44 (1) ◽  
pp. 8
Author(s):  
Caroline Pissetti ◽  
Gabriela Orosco Werlang ◽  
Jalusa Deon Kich ◽  
Marisa Cardoso
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Feed Additives ◽  
Resistant Bacteria ◽  
Resistance Profile ◽  
E Coli ◽  
Agar Diffusion Test ◽  
On Farm ◽  
Selection Of

Background: Antimicrobial resistant bacteria are considered a hazard not only for the treatment of animal diseases but also for public health. Commensal bacteria, such as Escherichia coli are considered a good indicator of antimicrobial resistance in the population, because it is a gut inhabitant and thus undergoes constant pressure of selection by the administration of antimicrobials. Regarding the public health, it is important to evaluate if resistant bacteria carried in the intestinal content of slaughter pigs can be found on the surface of pre chill carcasses. Therefore, the aims of this study were to evaluate the frequency of antimicrobial resistance in E. coli isolated from feces and pig carcasses; and to assess if multi-resistant isolates from both sources were phenotypically and genotypically related.Materials, Methods & Results: Two sampling cycles were conducted in three pig slaughterhouses (A, B and C). In each cycle, samples were collected form: i. feces deposited on the pen floor of the lairage; ii. surface of carcasses at the prechill step. Samples were submitted to a protocol of isolation and confirmation of Escherichia coli. Isolates were grouped according to the origin: feces (n = 355); carcasses (n = 319); and evaluated for antimicrobial resistance by agar diffusion test. Ninety two isolates presenting multidrug resistance profile were analyzed by pulsed-field gel eletrophoresis (PFGE). Among the 674 isolates of E. coli, 7.4% were susceptible to all tested antibiotics while 79.5% (536/674) were multi-resistant. The most frequent resistance patterns were displayed to tetracycline (Tet, 85.9%), ampicillin (Amp, 73.0%), sulfonamide (Sul, 70.0%), florfenicol (Flo, 65.0%) and nalidixic acid (Nal, 58.9%). The most frequent multi-resistance profile among isolates from both origins was [AmpFloNalSulTet]. Multiresistant isolates originated from feces and carcasses displaying genotypically related pulsotypes (≥70% similarity) were found in all three slaughterhouses.Discussion: In agreement with other studies, E. coli isolated from pig feces and carcasses demonstrated a high frequency of antimicrobial resistance and multi-resistance. The most frequent resistance profiles included antimicrobials frequently used on farm as well as drugs that have been banned as feed additives some years ago in Brazil. The selection of resistant strains may be related to the selection pressiondue to the use of antimicrobials in the pig production chain as well as the co-selection of resistance mediated by genes located in common genetic elements. Therefore, the ban of an individual drug is not always associated with the immediate disappearance of the resistance phenotype in the bacteria population. The fact that most multi-resistant E. coli isolates from carcasses belonged to pulsotypes related to those originated from feces samples indicates that resistant E. coli isolates selected on farm may be able to survive the slaughter process and be found on the carcass. In this case, the possibility of those strains being able to reach the population through the consumption of pork products may have to be considered. This hazard has motivated the ban of antimicrobial use in animals in some countries. However, the ban of antimicrobials use on farm is a controversial issue, due to the economical losses that may result from this measure. Therefore, the prudent use of antimicrobials on farm should be encouraged and its influence in the multi-resistance profile of the enteric microbiota should be further studied.

scholarly journals Isolation and Characterization of NDM-Positive Escherichia coli from Municipal Wastewater in Jeddah, Saudi Arabia

2016 ◽  
Vol 60 (9) ◽  
pp. 5223-5231 ◽  
Author(s):  
David Mantilla-Calderon ◽  
Muhammad Raihan Jumat ◽  
Tiannyu Wang ◽  
Pugalenthi Ganesan ◽  
Nada Al-Jassim ◽  
...  
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Saudi Arabia ◽  
Antibiotic Resistance ◽  
Health Concern ◽  
Resistant Bacteria ◽  
Potential Hazard ◽  
Content Type ◽  
E Coli ◽  
Untreated Wastewater

ABSTRACTThe emergence of resistance to last-resort antibiotics is a public health concern of global scale. Besides direct person-to-person propagation, environmental pathways might contribute to the dissemination of antibiotic-resistant bacteria and antibiotic resistance genes (ARGs). Here, we describe the incidence ofblaNDM-1, a gene conferring resistance to carbapenems, in the wastewater of the city of Jeddah, Saudi Arabia, over a 1-year period.blaNDM-1was detected at concentrations ranging from 104to 105copies/m3of untreated wastewater during the entire monitoring period. These results indicate the ubiquity and high incidence ofblaNDM-1in the local wastewater. To track the bacteria carryingblaNDM-1, we isolatedEscherichia coliPI7, a strain of sequence type 101 (ST101), from wastewater around the Hajj event in October 2013. Genome sequencing of this strain revealed an extensive repertoire of ARGs as well as virulence and invasive traits. These traits were further confirmed by antibiotic resistance profiling andin vitrocell internalization in HeLa cell cultures. Given that this strain remains viable even after a certain duration in the sewerage, and that Jeddah lacks a robust sanitary infrastructure to fully capture all generated sewage, the presence of this bacterium in the untreated wastewater represents a potential hazard to the local public health. To the best of our knowledge, this is the first report of ablaNDM-1-positiveE. colistrain isolated from a nonnosocomial environment in Saudi Arabia and may set a priority concern for the need to establish improved surveillance for carbapenem-resistantE. coliin the country and nearby regions.

scholarly journals Antimicrobial-resistant in Escherichia coli isolated from different effluent locations within Ahmadu Bello University, Zaria, Nigeria

2021 ◽  
Vol 19 (2) ◽  
pp. 89-97
Author(s):  
M.S. Yusuf ◽  
M.B. Aliyu ◽  
M. Babashani ◽  
Y.M. Yangora ◽  
U.S. Salisu ◽  
...  
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Biochemical Characterization ◽  
Agar Plate ◽  
Resistance Index ◽  
Resistant Bacteria ◽  
Biochemical Tests ◽  
E Coli ◽  
Antimicrobial Sensitivity ◽  
Municipal Water

The safety of municipal water is increasingly becoming of concern globally. Agricultural activities, industrial and residential effluents and community waste are ways through which water sources are contaminated and resistant bacteria can be spread via effluents to municipal water. The study aimed to isolate and determine the distribution of antimicrobial drug-resistant Escherichia coli from different points of the University sewer system in April 2018. A total of 48 samples were collected twice weekly from the six randomly selected inspection chamber sites out of the 14 identified sites. The selected sites of the sewer were located in some hostels, markets and health service areas within the ABU. main campus. The samples were processed by culturing on an EMB agar plate followed by biochemical characterization using conventional biochemical tests and Microbact 12E. An antimicrobial sensitivity test was also carried out using 13 different antibiotic discs. The results obtained revealed that the Community market had an isolation rate of 4(50%), while Sickbay had 3(37.5%) and Danfodiyo hostel with 2(25%). Multiple antimicrobial resistance index (MARI) was found to be 0.31 from four isolates (36%) of E. coli of which 3(75%) were sampled from Sickbay and 1(25%) from ABU Dam. Also, five isolates (45%) had MARI of 0.23, of which 2(40%) were sampled from Danfodiyo hostel, 1(20%) from Ribadu hostel and 2(40%) from Community market. The E. coli isolates were more resistant to Ampicillin, tetracycline and cephalothin. Other bacteria isolated were Klebsiella ozaenae, Hapnea alvei and Morganella morganii all with MARI of 0.31. There is a need for public health awareness on the effect of discharging antibiotic-resistant E. coli contaminated effluent into the environment and water bodies. Hence, the public health significance of recycling such water for domestic usage and agricultural purpose.

scholarly journals Prevalence and Characterization of Extended-Spectrum β-Lactamase-Producing Antibiotic-Resistant Escherichia coli and Klebsiella pneumoniae in Ready-to-Eat Street Foods

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 850
Author(s):  
Shobha Giri ◽  
Vaishnavi Kudva ◽  
Kalidas Shetty ◽  
Veena Shetty
Keyword(s):  
Escherichia Coli ◽  
Food Safety ◽  
Klebsiella Pneumoniae ◽  
Rural Areas ◽  
Significant Risk ◽  
Microbiological Quality ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
E Coli ◽  
Extended Spectrum

As the global urban populations increase with rapid migration from rural areas, ready-to-eat (RTE) street foods are posing food safety challenges where street foods are prepared with less structured food safety guidelines in small and roadside outlets. The increased presence of extended-spectrum-β-lactamase (ESBL) producing bacteria in street foods is a significant risk for human health because of its epidemiological significance. Escherichia coli and Klebsiella pneumoniae have become important and dangerous foodborne pathogens globally for their relevance to antibiotic resistance. The present study was undertaken to evaluate the potential burden of antibiotic-resistant E. coli and K. pneumoniae contaminating RTE street foods and to assess the microbiological quality of foods in a typical emerging and growing urban suburb of India where RTE street foods are rapidly establishing with public health implications. A total of 100 RTE food samples were collected of which, 22.88% were E. coli and 27.12% K. pneumoniae. The prevalence of ESBL-producing E. coli and K. pneumoniae was 25.42%, isolated mostly from chutneys, salads, paani puri, and chicken. Antimicrobial resistance was observed towards cefepime (72.9%), imipenem (55.9%), cefotaxime (52.5%), and meropenem (16.9%) with 86.44% of the isolates with MAR index above 0.22. Among β-lactamase encoding genes, blaTEM (40.68%) was the most prevalent followed by blaCTX (32.20%) and blaSHV (10.17%). blaNDM gene was detected in 20.34% of the isolates. This study indicated that contaminated RTE street foods present health risks to consumers and there is a high potential of transferring multi-drug-resistant bacteria from foods to humans and from person to person as pathogens or as commensal residents of the human gut leading to challenges for subsequent therapeutic treatments.

scholarly journals In vitro activity of antimicrobial peptide CDP-B11 alone and in combination with colistin against colistin-resistant and multidrug-resistant Escherichia coli

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kaitlin S. Witherell ◽  
Jason Price ◽  
Ashok D. Bandaranayake ◽  
James Olson ◽  
Douglas R. Call
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Peptide ◽  
Membrane Integrity ◽  
Antibiotic Resistance Genes ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
E Coli ◽  
Minimal Media

AbstractMultidrug-resistant bacteria are a growing global concern, and with increasingly prevalent resistance to last line antibiotics such as colistin, it is imperative that alternative treatment options are identified. Herein we investigated the mechanism of action of a novel antimicrobial peptide (CDP-B11) and its effectiveness against multidrug-resistant bacteria including Escherichia coli #0346, which harbors multiple antibiotic-resistance genes, including mobilized colistin resistance gene (mcr-1). Bacterial membrane potential and membrane integrity assays, measured by flow cytometry, were used to test membrane disruption. Bacterial growth inhibition assays and time to kill assays measured the effectiveness of CDP-B11 alone and in combination with colistin against E. coli #0346 and other bacteria. Hemolysis assays were used to quantify the hemolytic effects of CDP-B11 alone and in combination with colistin. Findings show CDP-B11 disrupts the outer membrane of E. coli #0346. CDP-B11 with colistin inhibits the growth of E. coli #0346 at ≥ 10× lower colistin concentrations compared to colistin alone in Mueller–Hinton media and M9 media. Growth is significantly inhibited in other clinically relevant strains, such as Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae. In rich media and minimal media, the drug combination kills bacteria at a lower colistin concentration (1.25 μg/mL) compared to colistin alone (2.5 μg/mL). In minimal media, the combination is bactericidal with killing accelerated by up to 2 h compared to colistin alone. Importantly, no significant red blood hemolysis is evident for CDP-B11 alone or in combination with colistin. The characteristics of CDP-B11 presented here indicate that it can be used as a potential monotherapy or as combination therapy with colistin for the treatment of multidrug-resistant infections, including colistin-resistant infections.

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