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In Vitro Synergistic Activity of Sulbactam in Combination with Imipenem Meropenem and Cefoperazone Against Carbapenem Resistant Acinetobacter baumannii Isolates
Mikrobiyoloji Bulteni 2014 Cilt 48 Sayı 2
Scopus Eşleşmesi Bulundu
16
Atıf
48
Cilt
311-315
Sayfa
🔓
Açık Erişim
Scopus Yazarları: Hatice Türk Dağı, Ugur Arslan, Hatit Kus, Inci Tuncer
Özet
Acinetobacter baumannii which is an opportunistic pathogen leading to nosocomial epidemics, exhibit high rates of antimicrobial resistance. Treatment of Acinetobacter infections is a challenge since most of the isolates are multiple antibiotic resistant. The aim of this study was to investigate minimum inhibitory concentrations (MICs) of sulbactam, imipenem, meropenem, and cefoperazone and in vitro synergistic activity of sulbactam in combination with imipenem, meropenem and cefoperazone against A baumannii isolates of hospitalized patients. Forty A.baumannii strains isolated from various clinical specimens and found to be resistant to carbapenems by disc diffusion method, were included in the study. The isolates were identified by conventional methods and VITEK 2 (bioMerieux, France) automated identification system. MICs of sulbactam, imipenem, meropenem, and cefoperazone were determined by the broth microdilution method according to the standards of CLSI and in vitro synergy test was performed using the checkerboard microdilution method. Synergistic, partial synergistic, additive, indifferent and antagonistic effects of drug combinations were evaluated with the fractional inhibitory concentration index (FICI). Interpretation of the FICI was as follows: ≤ 0.5 synergy; > 0.5 to < 1 partial synergy; 1 additive; >1 to < 4 indifference; and ≥ 4 antagonism. Forty A.baumannii isolates were resistant to imipenem and cefoperazone, but two were susceptible, seven were moderately susceptible and 31 were resistant to meropenem with the microdilution method. MIC values of the isolates for sulbactam were found to be 4 μg/ml in two, 8 μg/ml in five, 16 μg/ml in three, 32 μg/ml in 13, 64 μg/ml in three, 128 μg/ml in six and >128 μg/ml in eight isolates. According to the FICI; imipenem/sulbactam combination exhibited synergy in 18 (45%), partial synergy in 4 (10%) and indifferent effect in 2 (5%) isolates, the combination of meropenem and sulbactam showed synergy in 19 (48%), partial synergy in 3 (7.5%), and indifferent effect in 3 (7.5%) isolates, the combination of cefoperazone/ sulbactam demonstrated synergy in 18 (45%), partial synergy in 2 (5%), and indifferent effect in 2 (5%) isolates. There was no antagonistic effect with the tested combinations. In conclusion, MIC values of sulbactam were generally high in carbapenem-resistant A.baumannii strains. However, synergistic effect was detected in approximately half of the strains with the sulbactam/carbapenem combinations. The data obtained in this study should be supported by further advanced in vitro and clinical studies to predict the accurate clinical efficacy of sulbactam containing combinations on A.baumannii infections.
Anahtar Kelimeler (Scopus)
Cefoperazone Synergy Acinetobacter baumannii Carbapenem Resistance Sulbactam

Anahtar Kelimeler

Cefoperazone Synergy Acinetobacter baumannii Carbapenem Resistance Sulbactam

Makale Bilgileri

Dergi Mikrobiyoloji Bulteni
ISSN 03749096
Yıl 2014 / 4. ay
Cilt / Sayı 48 / 2
Sayfalar 311 – 315
Makale Türü Özgün Makale
Hakemlik Hakemli
Endeks SCI-Expanded
YÖKSİS Atıf 1
Yayın Dili İngilizce
Ülke TÜRKİYE Uluslararası
Şehir ANKARA
Kapsam Uluslararası
Toplam Yazar 4 kişi
Erişim Türü Elektronik
Erişim Linki Makaleye Git
Alan Sağlık Bilimleri Temel Alanı- Klinik Mikrobiyoloji

YÖKSİS Yazar Kaydı

Yazar Adı TÜRK DAĞI HATİCE,KUŞ HALİT,ARSLAN UĞUR,TUNCER EMİNE İNCİ
YÖKSİS ID 700392

Metrikler

YÖKSİS Atıf 1
Scopus Atıf 16
Yazar Sayısı 4