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Evaluation of the Efficacy of Colistin/Sulbactam Combination on Carbapenem-Resistant Acinetobacter baumannii Strains

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dc.contributor.author Altuncekic Yildirim, Arzu
dc.contributor.author Calgin, Mustafa Kerem
dc.contributor.author Cetinkol, Yeliz
dc.contributor.author Telli, Murat
dc.date.accessioned 2022-08-16T11:54:42Z
dc.date.available 2022-08-16T11:54:42Z
dc.date.issued 2016
dc.identifier.uri http://doi.org/10.5578/mb.26289
dc.identifier.uri http://www.mikrobiyolbul.org/linkout.aspx?pmid=27525401
dc.identifier.uri http://earsiv.odu.edu.tr:8080/xmlui/handle/11489/2044
dc.description.abstract Acinetobacter baumannii strains, are opportunistic pathogens that cause severe nosocomial infections that are difficult to treat due to development of resistance to multiple antibiotics. As the antibiotic choices to be used in treatment are limited, combinations of a variety of antibiotics are used. The aims of this study were to identify the minimal inhibitory concentration (MIC) values of colistin and sulbactam against A. baumannii isolates and to determine the in vitro activity of colistin-sulbactam combination. A total of 50 A. baumannii strains isolated from different clinical specimens (32 tracheal aspirates, 10 blood, 6 urine and 2 wound samples) were included in the study. The identification of bacteria was performed by traditional methods and Vitek-2 (BioMerieux, France) automated system. Antibiotic susceptibilities were detected by Mueller-Hinton agar disk diffusion method and Vitek-2 automated system and the results were interpreted according to the CLSI standards. MIC values of colistin and sulbactam against A. baumannii strains and in vitro interactions of colistin-sulbactam combinations were determined with the E-test (BioMerieux, France). Fractional inhibitory concentration (FIC) index was used for the detection of efficacy of drug combinations. The presence of oxacillinase and metallo-beta-lactamase (MBL) genes that lead carbapenem resistance was investigated by polymerase chain reaction (PCR), and pulsed-field gel electrophoresis (PFGE) was performed for the determination of clonal relationship. In our study, all strains (100%) were detected as susceptible to colistin, 48 (96%) to trimethoprim/sulphamethoxazole and 18 to (36%) tigecyclin; however all of them were resistant to the other studied antibiotics, including sulbactam and carbapenem. When the colistin-sulbactam combination was assessed according to FIC index, all strains were found to have antagonistic effect. All of the carbapenem-resistant strains were positive for OXA-51 and OXA-23, and 3 (6%) were positive for OXA-24. Among MBLs, OXA-58, OXA-48, IPM, SPM, SIM, GIM, VIM and NDM-1 genes were not detected. In the evaluation of PFGE results it was found that the clonal distribution of the strains, except one, were all pulsotype A. In the assessment of in vitro efficacy of the colistin-sulbactam combination against A. baumannii strains with multidrug resistance, antagonistic effect was observed in all strains. In the resistance and clonal analysis it was determined that the strains belonged to the same clone, and they had the same resistance genes and therefore the result of the in vitro activity was considered to have similar effect among all strains. It was decided that especially in units where critical patients are monitored and where resistant strains that are difficult to treat are isolated, performing synergy studies may be beneficial for the selection of combination treatment and the determination of the treatment combination to be chosen specifically for the hospital or even the unit. en_US
dc.language.iso tur en_US
dc.publisher ANKARA MICROBIOLOGY SOC, HACETLEPE UNIV FACULTY MEDICINE DEPT MICROBIOLOGY, 06100 ANKARA, TURKEY en_US
dc.relation.isversionof 10.5578/mb.26289 en_US
dc.rights info:eu-repo/semantics/openAccess en_US
dc.subject Acinetobacter baumannii; synergy; colistin; sulbactam en_US
dc.subject VITRO SYNERGISTIC ACTIVITY; COLISTIN; SULBACTAM; IMIPENEM; MEROPENEM; ANTIMICROBIALS; CEFOPERAZONE en_US
dc.title Evaluation of the Efficacy of Colistin/Sulbactam Combination on Carbapenem-Resistant Acinetobacter baumannii Strains en_US
dc.type article en_US
dc.relation.journal MIKROBIYOLOJI BULTENI en_US
dc.contributor.department Ordu Üniversitesi en_US
dc.contributor.authorID 0000-0003-1141-9838 en_US
dc.contributor.authorID 0000-0003-4236-6177 en_US
dc.contributor.authorID 0000-0003-4940-4498 en_US
dc.identifier.volume 50 en_US
dc.identifier.issue 3 en_US
dc.identifier.startpage 460 en_US
dc.identifier.endpage 465 en_US


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