In-vitro effect of concomitant two B-lactams against multiple drug resistant Acinetobacter Baumannii isolates

Abstract

With the increase of infectious hub disease and the spread of drug resistance of microorganisms, this cross-sectional study was conducted to investigate the simultaneous effect of two beta-lactams on Acinetobacter Baumannii isolates with multi-drug resistance in the culture medium. Based on the obtained results, the combination of piperacillin tazobactam / imipenem had the most synergistic effect against Acinetobacter Baumannii. Background Today, the drug resistance of Gram-negative bacteria has become a global problem, especially the infection of these bacteria is very dangerous, especially in patients who are hospitalized in the intensive care unit of hospitals. Therefore, in this study, we intend to investigate the simultaneous effect of two beta-lactams on Acinetobacter Baumannii isolates with multidrug resistance in the culture medium. Materials and methods: This is a cross-sectional descriptive study that includes 30 isolates of Acinetobacter Baumannii that were identified from the patients of the infectious department of Imam Reza Hospital and Sinai Hospital after microbial culture and determination of bacterial strain and multi-microbial resistance and were included in the study. Demographic information of patients and bacterial isolates were recorded. The treatment regimen of the patients included two beta-lactams at the same time as follows: A) Imipenem + Meropenem b) Piperacillin tazobactam + imipenem C) piperacillin tazobactam + meropenem Different concentrations of antibiotics were prepared individually and both together for each regimen (MIC 4, 2, 1, 0.5, 0.25, 0.125) and with the purified bacterial sample with a concentration of 5*105 CFU/ml and plates the cultures were incubated at 37°C for 24-48 hours. The fraction inhibitory concentration index (FIC) was used to determine the synergy of antibiotics. The antibacterial activity of antibiotics will also be evaluated in the form of lethality duration. Results: In this study, all 30 isolates identified as Acinetobacter Baumannii had the same biochemical pattern. Their biochemical characteristics included the ability to oxidize glucose in the OF environment, the ability to use citrate as the only carbon source, negative oxidase, negative hydrogen sulfide, negative endol, and growth on the medium. Out of 30 examined patients, 12 (40%) were women and 18 (60%) were men. In terms of age, the patients were at least 3 days old and at most 75 years old. Out of the total of 30 isolates of Acinetobacter Baumannii investigated, 19 cases (63.33%) were isolated from blood culture, 8 cases (26.66%) from urine culture, and 3 cases (10%) from catheter culture.