In vitro and in vivo potency of polymyxin B against IMP-type metallo-β-lactamase-producing Pseudomonas aeruginosa

Multidrug-resistant Pseudomonas aeruginosa, especially metallo-β-lactamase (MBL)-producing P. aeruginosa, is an important pathogen in nosocomial infection and emergence of this pathogen has revived interest in polymyxin B (PMB) and colistin (COL). In this study, we evaluated the efficacies of PMB, COL and other antipseudomonal agents against IMP-type MBL-producing P. aeruginosa both in vitro and in vivo. A total of 75 isolates of blaIMP-positive P. aeruginosa obtained from clinical specimens (94.6% of isolates demonstrated resistance to β-lactam, fluoroquinolone and aminoglycoside agents) were evaluated in the in vitro study. More than 90% of the examined isolates were susceptible to PMB (minimum inhibitory concentration for 50/90% of the isolates (MIC50/MIC90) 4/4 mg/L), although COL was less potent (MIC50/MIC90 8/16 mg/L). Cyclophosphamide-treated mice were intraperitoneally inoculated with blaIMP-positive P. aeruginosa. Treatment with PMB, but not COL, imipenem/cilastatin or aztreonam, significantly improved the survival rate and decreased the number of bacteria in the blood in a dose-dependent manner. Our results indicate that, among the agents studied, PMB is the most effective agent against blaIMP-positive P. aeruginosa.