Evaluation of synergistic activity of antibiotic combinations in extensive drug-resistant Acinetobacter species using checkerboard assay

Halim, Rania M. Abdel; Saber, Sally; Fahim, Noha Alaa Eldin

doi:10.1099/jmm.0.001639

Cited by 3 publications

(1 citation statement)

References 47 publications

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“…Recently, PR was analyzed to recover susceptibility of extensively drug-resistant (XDR) bacterial isolates to fluoroquinolones [ 12 ]. Moreover, combinations of MEM plus AK and MEM plus TGC have recently been widely used in clinical settings in Egypt after they have been tested as synergistic combinations[ 13 , 14 ]. However, the pattern of XDR GNB particularly those which are CR are changeable by time which leads to an urgent demand to test the susceptibility of the circulating XDR pathogens [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Propranolol restores susceptibility of XDR Gram-negative pathogens to meropenem and Meropenem combination has been evaluated with either tigecycline or amikacin

Mabrouk¹,

Abdellatif²,

Zaid³

et al. 2023

BMC Microbiol

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Background Infection with extensive-drug-resistant (XDR) carbapenem-resistant (CR) Gram-negative bacteria (GNB) are viewed as a serious threat to human health because of the limited therapeutic options. This imposes the urgent need to find agents that could be used as adjuvants or combined with carbapenems to enhance or restore the susceptibility of XDR CR- GNB. Therefore, this study aimed to examine the effect of propranolol (PR) in combination with Meropenem (MEM) on the susceptibility profile of XDR CR-GNB recovered from severely infected patients as well as to evaluate combining MEM with either tigecycline (TGC) or amikacin (AK). Methods A total of 59 non-duplicate CR- GNB were investigated for carbapenemase production by the major phenotypic methods. Molecular identification of five major carbapenemase-coding genes was carried out using polymerase chain reactions (PCR). Antimicrobial susceptibility tests were carried out using standard methods. Phenotypic and genotypic relatedness was carried out using the heatmap and ERIC PCR analysis. PR, 0.5 -1 mg/mL against the resulting non-clonal XDR CR-GNB pathogens were evaluated by calculating the MIC decrease factor (MDF). A combination of MEM with either AK or TGC was performed using the checkerboard assay. Results A total of 21 (35.6%) and 38 (64.4%) CR-GNB isolates were identified as enterobacterial isolates (including 16 (27.1%) Klebsiella Pneumoniae and 5 (8.5%) Escherichia coli) and non-fermentative bacilli (including, 23 (39%), Acinetobacter baumannii, and 15 (25.4%) Pseudomonas aeruginosa). The heatmap and ERIC PCR analysis resulted in non-clonal 28 XDR CR isolates. PR, at a concentration of 0.5 mg /ml, decreased MICs values of the tested XDR CR isolates (28; 100%) and restored susceptibility of only 4 (14.3%) isolates. However, PR (1 mg/mL) when combined with MEM has completely (28; 100%) restored the susceptibility of the tested XDR CR- GNB to MEM. The MEM + AK and MEM + TGC combination showed mostly additive effects (92.8% and 71.4%, respectively). Conclusion PR at a concentration of 1 mg/mL restored the susceptibility of XDR CR- GNB to MEM which is considered a promising result that should be clinically investigated to reveal its suitability for clinical use in patients suffering from these life-threatening pathogens.

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Section: Introductionmentioning

confidence: 99%

Propranolol restores susceptibility of XDR Gram-negative pathogens to meropenem and Meropenem combination has been evaluated with either tigecycline or amikacin

Mabrouk¹,

Abdellatif²,

Zaid³

et al. 2023

BMC Microbiol

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Enhanced bactericidal performance of textiles through compound antimicrobial agents

Huang,

Li,

Chen

et al. 2024

Biointerphases

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This study aims to explore the essential functional requirements associated with controlling the proliferation of microbes in the domain of textiles used in public health areas. Herein, three antimicrobial agents, specifically iodopropylbutylcarbamate (IPBC), 1-hydroxypyridine-2-thioketone zinc (ZPT), and 2-octyl-3-isothiazolinone (OIT), were chosen for fabric finishing based on their notable effectiveness, minimal toxicity, cost-efficiency, and chemical stability. Utilizing Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) as representative bacterial strains, the Minimum Inhibitory Concentration (MIC50) of individual and combined antimicrobial agents was measured, and their antimicrobial effectiveness was rigorously evaluated. Concurrently, the antimicrobial effectiveness, whiteness, and mechanical durability of the fabric following antimicrobial treatment were thoroughly examined. The results demonstrate that some combinations of the three antimicrobial agents elicit additive effects on both S. aureus and E. coli. Notably, at an equivalent ratio of IPBC, ZPT, and OIT and a total concentration of 0.2 wt. %, the inhibition rates against both bacterial strains surpass 99%. Upon application to nylon fabric, the treated material demonstrates significant antimicrobial properties, with minimal reduction observed in the whiteness and tensile strength of the treated nylon. This study provides practicable strategies relevant to the production of textiles endowed with antimicrobial properties.

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Combinations of Antibiotics Effective against Extensively- and Pandrug-Resistant Acinetobacter baumannii Patient Isolates

Halim,

Carr,

Fliorent

et al. 2024

Microorganisms

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Infections due to drug-resistant Acinetobacter baumannii strains are increasing and cause significant morbidity and mortality, especially in hospitalized and critically ill patients. A. baumannii rapidly develops resistance to numerous antibiotics, and antibiotics traditionally used against this deadly pathogen have been failing in recent years, highlighting the need to identify new treatment strategies. Treatment options that have shown promise include revisiting common antibiotics not typically used against A. baumannii, evaluating new antibiotics recently introduced to market, and identifying combinations of antibiotics that display synergistic interactions. In this study, we characterized the antibiotic susceptibility profiles of extensively (XDR) and pandrug-resistant (PDR) A. baumannii patient isolates. We examined the potency of 22 standard-of-care antibiotics and the newer antibiotics eravacycline, omadacycline, and plazomicin against these strains. Furthermore, we examined combinations of these antibiotics against our collection to identify synergistic effects. We found that this collection is highly resistant to most or all standard-of-care antibiotics, except for minocycline and rifampin. We show that eravacycline and omadacycline are effective against these strains based on minimum inhibitory concentrations. We also identified two highly effective combinations, cefepime and amikacin and cefepime and ampicillin–sulbactam, which exhibited high rates of synergy against this collection. This information is valuable in our battle against highly drug resistant and virtually untreatable A. baumannii infections.

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Evaluation of synergistic activity of antibiotic combinations in extensive drug-resistant Acinetobacter species using checkerboard assay

Cited by 3 publications

References 47 publications

Propranolol restores susceptibility of XDR Gram-negative pathogens to meropenem and Meropenem combination has been evaluated with either tigecycline or amikacin

Propranolol restores susceptibility of XDR Gram-negative pathogens to meropenem and Meropenem combination has been evaluated with either tigecycline or amikacin

Enhanced bactericidal performance of textiles through compound antimicrobial agents

Combinations of Antibiotics Effective against Extensively- and Pandrug-Resistant Acinetobacter baumannii Patient Isolates

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