year 17, Issue 2 (March - April 2023)
Iran J Med Microbiol 2023, 17(2): 218-229 |
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Mahmoud Farhan S, Mahmoud Abd El-Baky R, Mohammad Abdalla S A, Osama El-Gendy A, Farag Azmy A. Efficacy of Amikacin and Imipenem Against Multi-Drug Resistant Gram-Negative Bacteria Isolated from Wound Infections, Egypt. Iran J Med Microbiol 2023; 17 (2) :218-229
URL: http://ijmm.ir/article-1-1829-en.html
URL: http://ijmm.ir/article-1-1829-en.html
Sara Mahmoud Farhan 
1, Rehab Mahmoud Abd El-Baky2 , Salah aldin Mohammad Abdalla3 , Ahmed Osama El-Gendy4 , Ahmed Farag Azmy4
1, Rehab Mahmoud Abd El-Baky2 , Salah aldin Mohammad Abdalla3 , Ahmed Osama El-Gendy4 , Ahmed Farag Azmy4
1- Department of Microbiology and Immunology, Faculty of Pharmacy, Deraya University, Minia, Egypt , Sara.mahmoud@deraya.edu.eg
2- Department of Microbiology and Immunology, Faculty of Pharmacy, Deraya University, Minia, Egypt
3- Department of Microbiology and Immunology, Faculty of Pharmacy, Suez Canal University, Ismalia, Egypt
4- Department of Microbiology and Immunology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
2- Department of Microbiology and Immunology, Faculty of Pharmacy, Deraya University, Minia, Egypt
3- Department of Microbiology and Immunology, Faculty of Pharmacy, Suez Canal University, Ismalia, Egypt
4- Department of Microbiology and Immunology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
Abstract: (1526 Views)
Background and Aim: Gram-negative pathogens are considered the common cause of wound infections associated with increased mortality and morbidity rates. Antibiotics combination has been used to overcome this problem. In this study, we identify Gram-negative pathogens found in wound infections and assess the in-vitro efficacy of a combination of amikacin and imipenem against the resistant isolated pathogens.
Materials and Methods: One hundered fifty gram-negative bacteria were collected from two hundered patients suffering from different wound infections. Patients attended Minia University Hospitals,Egypt at period from January 2019- January 2020 and they were followed up periodically as a routine work in the hospitals. Swabs streaked on various media as Nutrient agar, MacConkey agar, Eosin methylene blue agar and cetrimide agar. The antimicrobial susceptibility of the identified pathogens was tested using the Kirby-Bauer method. Conventional PCR was used to detect the prevalence of bla-IMP and AAC (6’)-Ib genes. The effect of the tested combination was assessed by checkerboard technique and time-killing assay.
Results: Escherichia coli 38.6% was the most common isolated pathogen, followed by Proteus spp 30%, P. aeruginosa 21.4%, Klebsiella spp. 5.7%, and Acinetobacter baumannii 4.3%. The isolates were completely resistant to Ampicillin/sulbactam, Amoxicillin/clavulanic, Cephalothin, Cefadroxil, Ciprofloxacin, Ceftazidime and Ofloxacin. Bla-IMP was detected in all Klebsiella spp., E. coli (85.2%), A. baumannii (66.7%), Proteus spp. (38.1%) and P. aeruginosa (33.35%). aac(6’)-Ib was detected among E. coli, P. aeruginosa and Proteus spp. The Checkerboard test showed a significant decrease in bacterial count in the presence of combination indicating a synergistic effect with FICIs ≤0.5. Time-kill assay showed a significant decrease in the bacterial count after 12h.
Conclusion: The studied combinations of antibiotics showed synergistic effects against the tested Gram-negative bacteria which can help in the control and treatment of serious wound infections.
Keywords: Gram-negative bacteria, imipenem, amikacin, Time kill curve, checkerboard assay, drug combination, synergism
Type of Study: Original Research Article |
Subject:
Antibiotic Resistance
Received: 2022/08/22 | Accepted: 2023/01/28 | ePublished: 2023/03/30
Received: 2022/08/22 | Accepted: 2023/01/28 | ePublished: 2023/03/30
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