SYNERGISTIC COMBINATIONS OF BROAD SPECTRUM ANTIBIOTICS AGAINST ACINETOBACTER SPP

Authors

  • Sadia Zafar Jinnah University for Women
  • Syed Baqir Shyum Naqvi Hamdard University
  • Tanveer Abbas University of Karachi
  • Faaiza Qazi1 Jinnah University for Women

Keywords:

Double Disc Synergy, Resistance, Broad spectrum

Abstract

Objective: The present study was aimed to investigate the resistant pattern of Acinetobacter spp. against 4 broad spectrum antibiotics and the synergistic activity between 3 different combinations of antimicrobials.

Methods: For conducting research we obtained 52 sample of bacterial spp. from different infection sites of patients admitted to tertiary care hospital. The procedure was carried out in two parts. At first the Kirby Bauer Disc Diffusion Method was adopted to evaluate resistance pattern according to CLSI standards. 08 broad spectrum antibiotics were used. In second part of the study the synergistic activity between different combinations of selected antibiotics were estimated by Double Disc Synergy Method.

Results: It was evident that male patients were highly infected by Acinetobacter spp. The organism was found responsible for infecting the respiratory tract of elderly patients at high rate. Colistin and Polymixin effectively inhibited Acinetobacter spp. 98% each. On contrary, it was found to be highly resistant against β-lactam (98%). Cephalosporins, Quinolones, Aminoglycosides, Carbapenem were also proven inactive when used alone. All the isolates when subjected to DDS test. Highest synergy was observed between combinations of Fosfomycin-Polymixin (90.38%), Almost 52% isolates were successfully inhibited when the combination of Colistin and Fosfomycin was checked. However, more than 61% isolates showed the highest resistance when the Polymixin-Imipenemwere used together. However, all the tested combinations were highly effective against Acinetobacterisolates obtained from tracheal aspirate.

 

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Author Biography

Sadia Zafar, Jinnah University for Women

Pharmaceutic

References

Zhang Y, Chen F, Sun E, Ma R, Qu C, Ma L. In vitro antibacterial activity of combinations of fosfomycin, minocycline and polymyxin B on pan drug resistant Acinetobacterbaumannii ExpTher Med. 2013;5:1737-39.

Principe L, D'Arezzo S, Capone A, Petrosillo N, Visca P. In vitro activity of tigecycline in combination with various antimicrobials against multidrug resistant Acinetobacterbaumannii. Ann Clin Microbiol Antimicrob 2009;8:18.

Charles R Bonapace, Roger L White, Lawrence V Friedrich, John A Bosso. Evaluation of antibiotic synergy against Acinetobacterbaumannii: a comparison with Etest, time-kill, and checkerboard methods. Diagn Microbiol Infect Dis 2000;38:43-50.

Dai XT, Sun FJ, Chen ZH, Luo GM, Feng W, Xiong W, et al. The Epidemiology and Resistance Mechanisms of Acinetobacterbaumannii Isolates from the Respiratory Department ICU of a Hospital in China. Microb Drug Resist. 2014; 20(6):618-22.

Mahzounieh M, Khoshnood S, Ebrahimi A, Habibian S, Yaghoubian M. Detection of antiseptic-resistance genes in pseudomonas and acinetobacter spp. isolated from burn patients. Jundishapur J Nat Pharm Prod 2014;9:e15402.

Dettori M, Piana A, Deriu MG, Lo Curto P, Cossu A, Musumeci R, et al. Outbreak of multidrug-resistant Acinetobacterbaumannii in an intensive care unit. New Microbiol 2014;37:185-91.

Poulikakos P, Tansarli GS, Falagas ME. Combination antibiotic treatment versus monotherapy for multidrug-resistant, extensively drug-resistant, and pandrug-resistant Acinetobacter infections: a systematic review. Eur J Clin Microbiol Infect Dis 2014;33:1675-85.

David W Wareham, David C Bean. In-vitro activity of polymyxin B in combination with imipenem, rifampicin and azithromycin versus multidrug resistant strains of Acinetobacterbaumannii producing OXA-23 carbapenemases. Ann Clin Microbiol Antimicrob 2006;21:5:10.

Robert A. Bonomo1 and dora szabo mechanisms of multidrug resistance in Acinetobacter Species and Pseudomonas aeruginosa. Clin Infect Dis 2006;43 Suppl 2:S49-S56.

Lee JH, Choi CH, Kang HY, Lee JY, Kim J, Lee YC, et al. Differences in phenotypic and genotypic traits against antimicrobial agents between Acinetobacterbaumannii and Acinetobacter genomicspecies 13TU. J Antimicrobial Chemother 2007;59:633–9.

Jana M Swenson, George E Killgore, Fred C. Tenover Antimicrobial Susceptibility Testing of Acinetobacterspp. By NCCLS broth microdilution and disk diffusion methods. J Clin Microbiol 2004;42:5102-08.

Spoorthi N Jain, Vishwanatha T, Reena V, Divyashree BC, Aishwarya Sampath, Siddhalingeshwara KG, Venugopal N, et al. Antibiotic synergy test: checkerboard method on multidrug resistant Pseudomonas Aeruginosa IRJP 2011;2:196-8.

Tan TY, Lim TP, Lee WH, Sasikala S, Hsu LY, Kwa AL. In vitro antibiotic synergy in extensively drug-resistant Acinetobacterbaumannii: The effect of testing by time-kill, checkerboard, and etest methods Antimicrob. Agents Chemother 2011;55:436.

Enas A Daef, Ismail S Mohamed, Ahmed S Ahmed, Nahla M Elsherbiny, Ibrahim M. Sayed Evaluation of different phenotypic assays for the detection of metallo-β-lactamase production incarbapenemsusceptible and resistant Acinetobacterbaumanniiisolates. J Am Sci 2012;8:292-9.

Hortiwakul T, Chayakul P, Ingviya N, Chayakul V. In vitro activity of colistin, Fosfomycin, and Piperacillin/tazobactam Against Acinetobacterbaumanniiand Pseudomonas aeruginosain Songklanagarind Hospital, Thailand. J Infect Dis Antimicrob Agents 2009;26:91-6.

Wareham DW, Gordon NC, Hornsey M. In vitro activity of teicoplanin combined with colistin versus multidrug-resistant strains of Acinetobacterbaumannii. J Antimicrob Chemother 2011;66:1047–51.

Divyashree BC, Vishwanatha T, Spoorthi N Jain, Reena V, Aishwarya Sampath, Siddhalingeshwara KG, et al. Valuation Of In vitro synergy between amipicillin and kanamycin against. Staphylococcus Aureus. J Drug Delivery Ther 2012:2:144-6.

Sueke H, Kaye SB, Neal T, Hall A, Tuft S, Christopher M. Parry an in vitro investigation of synergy or antagonism between antimicrobial combinations against isolatesfrom bacterial keratitis. Invest Ophthalmol Visual Sci 2010:51:4151-5.

Soltani R, Khalili H, Shafiee F. Double-disk synergy test for detection of synergistic effect between antibiotics against nosocomial strains of Staphylococcus aureus. J Res Pharm Practice 2012;1:21-4.

Tatman-Otkun M, Gürcan S, Ozer B, Shokrylanbaran N. Annual trends in antibiotic resistance of nosocomial Acinetobacterbaumannii strains and the effect of synergistic antibiotic combinations. Microbiol 2004;27:21-8.

Robert A. Bonomo and dora szabo clinical infectious diseases september mechanisms of multidrug resistance in Acinetobacter species and Pseudomonas aeruginosa. 2006;43 Suppl 2:S49-S56.

Lee JH, Choi CH, Kang HY, Lee JY, Kim J, Lee YC, et al. Differences in phenotypic and genotypic traits against antimicrobial agents between Acinetobacterbaumannii and Acinetobacter genomicspecies 13TU. J Antimicrobial Chemother 2007;59:633–9.

Sinha M, Srinivasa H, Macaden R. Antibiotic resistance profile & extended spectrum beta-lactamase (ESBL) production in Acinetobacterspecies. Indian J Med Res 2007;126:63-7.

Yan JJ, Wu JJ, Tsai SH, Chuang CL. Comparison of the double-disk, combined disk, and Etest methods for detecting metallo-β-lactamases in gram-negative bacilli. Diagn Microbiol Infect Dis 2004;49:5-11.

Galani I, Kontopidou F, Souli M, Rekatsina PD, Koratzanis E, Deliolanis J, et al. Colistinsusceptibility testing by Etest and disk diffusion methodsInternational. J Antimicrobial Agents 2008;31:434-9.

Bauer AW, Kirby WMM, Sherris JC, Tuck M. Antibiotics susceptibility testing by a standardized single disc method. Am J Clin Pathol 1966;45:493-6.

National Committee for Clinical Laboratory Standards. Performance standard for antimicrobial disc susceptibility test. 5th ed. Villanova PA: NCC Document; 1993. p. M2-A5.

Clinical and laboratory standards institute, Performance standard for antimicrobial susceptibility testing X. CLSI, Wayne PA. CLSI Document M; 1993;29(3):100-S19.

Eliopoulos GM, RC moelleringjr. Antimicrobial combinations. In: V Lorian. ed, Antibiotics in Laboratory Medicines. 4thed. The Williams & Wilkins Co, Baltimore, Md; 1996. p. 330-96.

Özseven AG, Çetin ES, Arıdoğan BC, Özseven L. In vitro synergistic activity of carbapenems in combination with other antimicrobial agents against multidrug-resistant Acinetobacterbaumannii Afr J Microbiol Res 2012;6:2985-92.

Gordon NC, Png K, Wareham DW. Potent synergy and sustained bactericidal activity of a vancomycin-colistin combination versus multidrug-resistant strains of Acinetobacterbaumannii. Antimicrobial Agents Chemother 2010;54:5316–22.

Rabadia A, Kamat SD, Kamat DV. Study of synergistic action of cefotaxime and terminalia chebula on acinetobacter baumannii using checkerboard assay. Int J Pharm Pharm Sci 2013;5:830-2.

Clinical and Laboratory Standards Institute, Performance standard for antimicrobial susceptibility testing. CLSI Wayne PA. CLSI Document 2013;33(1):M100-S23.

Published

01-04-2015

How to Cite

Zafar, S., S. B. S. Naqvi, T. Abbas, and F. Qazi1. “SYNERGISTIC COMBINATIONS OF BROAD SPECTRUM ANTIBIOTICS AGAINST ACINETOBACTER SPP”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 7, no. 4, Apr. 2015, pp. 214-7, https://journals.innovareacademics.in/index.php/ijpps/article/view/4305.

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