year 17, Issue 2 (March - April 2023)                   Iran J Med Microbiol 2023, 17(2): 218-229 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

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
1- Department of Microbiology and Immunology, Faculty of Pharmacy, Deraya University, Minia, 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:   (1258 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.

Full-Text [PDF 574 kb]   (518 Downloads) |   |   Full-Text (HTML)  (249 Views)  
Type of Study: Original Research Article | Subject: Antibiotic Resistance
Received: 2022/08/22 | Accepted: 2023/01/28 | ePublished: 2023/03/30

1. Petruzziello A, Marigliano S, Loquercio G, Cozzolino A, Cacciapuoti C. Global epidemiology of hepatitis C virus infection: An up-date of the distribution and circulation of hepatitis C virus genotypes. World J Gastroenterol. 2016;22(34):7824-40. [DOI:10.3748/wjg.v22.i34.7824] [PMID] [PMCID]
2. Cooke GS, Lemoine M, Thursz M, Gore C, Swan T, Kamarulzaman A, et al. Viral hepatitis and the Global Burden of Disease: a need to regroup. J Viral Hepat. 2013;20(9):600-1. [DOI:10.1111/jvh.12123] [PMID]
3. Mohamoud YA, Mumtaz GR, Riome S, Miller D, Abu-Raddad LJ. The epidemiology of hepatitis C virus in Egypt: a systematic review and data synthesis. BMC Infect Dis. 2013;13(1):288. [DOI:10.1186/1471-2334-13-288] [PMID] [PMCID]
4. Elgharably A, Gomaa AI, Crossey MME, Norsworthy PJ, Waked I, Taylor-Robinson SD. Hepatitis C in Egypt - past, present, and future. Int J Gen Med. 2017;10:1-6. [DOI:10.2147/IJGM.S119301] [PMID] [PMCID]
5. Ditah I, Ditah F, Devaki P, Ewelukwa O, Ditah C, Njei B, et al. The changing epidemiology of hepatitis C virus infection in the United States: National health and nutrition examination survey 2001 through 2010. J Hepatol. 2014;60(4):691-8. [DOI:10.1016/j.jhep.2013.11.014] [PMID]
6. Lu M, Li J, Rupp LB, Zhou Y, Holmberg SD, Moorman AC, et al. Changing trends in complications of chronic hepatitis C. Liver Int. 2018;38(2):239-47. [DOI:10.1111/liv.13501] [PMID] [PMCID]
7. de Oliveria Andrade LJ, D'Oliveira A, Melo RC, De Souza EC, Costa Silva CA, Paraná R. Association between hepatitis C and hepatocellular carcinoma. J Glob Infect Dis. 2009;1(1):33-7. [DOI:10.4103/0974-777X.52979] [PMID] [PMCID]
8. Bennett JE, Dolin R, Blaser MJ. Mandell, douglas, and bennett's principles and practice of infectious diseases E-book: Elsevier health sciences; 2019.
9. Geddawy A, Ibrahim YF, Elbahie NM, Ibrahim MA. Direct acting anti-hepatitis C virus drugs: clinical pharmacology and future direction. J Transl int Med. 2017;5(1):8-17. [DOI:10.1515/jtim-2017-0007] [PMID] [PMCID]
10. Ji F, Wei B, Yeo YH, Ogawa E, Zou B, Stave CD, et al. Systematic review with meta-analysis: effectiveness and tolerability of interferon-free direct-acting antiviral regimens for chronic hepatitis C genotype 1 in routine clinical practice in Asia. Aliment Pharmacol Ther. 2018;47(5):550-62. [DOI:10.1111/apt.14507] [PMID]
11. Wei B, Ji F, Yeo YH, Ogawa E, Stave CD, Dang S, et al. Systematic review and meta-analysis: real-world effectiveness of direct-acting antiviral therapies in chronic hepatitis C genotype 3 in Asia. BMJ Open Gastroenterol. 2018;5(1):e000209. [DOI:10.1136/bmjgast-2018-000209] [PMID] [PMCID]
12. Liang TJ, Ghany MG. Current and future therapies for hepatitis C virus infection. N Engl J Med. 2013;368(20):1907-17. [DOI:10.1056/NEJMra1213651] [PMID] [PMCID]
13. Castillo I, Rodríguez-Iñigo E, López-Alcorocho JM, Pardo M, Bartolomé J, Carreño V. Hepatitis C Virus Replicates in the Liver of Patients Who Have a Sustained Response to Antiviral Treatment. Clin Infect Dis. 2006;43(10):1277-83. [DOI:10.1086/508198] [PMID]
14. Hetta HF, Mehta MJ, Shata MTM. Gut immune response in the presence of hepatitis C virus infection. World J Immunol. 2014;4(2):52-62. [DOI:10.5411/wji.v4.i2.52]
15. Mekky MA, Sayed HI, Abdelmalek MO, Saleh MA, Osman OA, Osman HA, et al. Prevalence and predictors of occult hepatitis C virus infection among Egyptian patients who achieved sustained virologic response to sofosbuvir/daclatasvir therapy: a multi-center study. Infect Drug Resist. 2019;12:273-9. [DOI:10.2147/IDR.S181638] [PMID] [PMCID]
16. Fallahi P, Ferri C, Ferrari SM, Corrado A, Sansonno D, Antonelli A. Cytokines and HCV-related disorders. Clin Dev Immunol. 2012;2012. [DOI:10.1155/2012/468107] [PMID] [PMCID]
17. Antonelli A, Ferrari SM, Ruffilli I, Fallahi P. Cytokines and HCV-related autoimmune disorders. Immunol Res. 2014;60(2):311-9. [DOI:10.1007/s12026-014-8569-1] [PMID]
18. Kim AY, Kuntzen T, Timm J, Nolan BE, Baca MA, Reyor LL, et al. Spontaneous Control of HCV Is Associated With Expression of HLA-B*57 and Preservation of Targeted Epitopes. Gastroenterology. 2011;140(2):686-96.e1. [DOI:10.1053/j.gastro.2010.09.042] [PMID] [PMCID]
19. Grakoui A, Shoukry NH, Woollard DJ, Han J-H, Hanson HL, Ghrayeb J, et al. HCV persistence and immune evasion in the absence of memory T cell help. Science. 2003;302(5645):659-62. [DOI:10.1126/science.1088774] [PMID]
20. Shoukry NH, Grakoui A, Houghton M, Chien DY, Ghrayeb J, Reimann KA, et al. Memory CD8+ T cells are required for protection from persistent hepatitis C virus infection. J Exp Med. 2003;197(12):1645-55. [DOI:10.1084/jem.20030239] [PMID] [PMCID]
21. Gad YZ, Mouas N, Abdel-Aziz A, Abousmra N, Elhadidy M. Distinct immunoregulatory cytokine pattern in Egyptian patients with occult Hepatitis C infection and unexplained persistently elevated liver transaminases. Asian J Transfus Sci. 2012;6(1):24-8. [DOI:10.4103/0973-6247.95046] [PMID] [PMCID]
22. Flynn JK, Dore GJ, Hellard M, Yeung B, Rawlinson WD, White PA, et al. Maintenance of Th1 hepatitis C virus (HCV)-specific responses in individuals with acute HCV who achieve sustained virological clearance after treatment. J Gastroenterol Hepatol. 2013 (11):1770-81. [DOI:10.1111/jgh.12265] [PMID] [PMCID]
23. Kandeel A, Genedy M, El-Refai S, Funk AL, Fontanet A, Talaat M. The prevalence of hepatitis C virus infection in Egypt 2015: implications for future policy on prevention and treatment. Liver Int. 2017;37(1):45-53. [DOI:10.1111/liv.13186] [PMID] [PMCID]
24. Scheel TKH, Rice CM. Understanding the hepatitis C virus life cycle paves the way for highly effective therapies. Nat Med. 2013;19(7):837-49. [DOI:10.1038/nm.3248] [PMID] [PMCID]
25. Abd Alla MDA, El Awady MK. Hepatitis C Virus RNA Strands Detection in Peripheral Blood Mononuclear Cells Legitimizes Virus Eradication in Negative Serum PCR Naïve and Post-treatment Patients. J Clin Transl Hepatol. 2017;5(1):1-8. [DOI:10.14218/JCTH.2016.00054] [PMID] [PMCID]
26. Hanno AFF, Mohiedeen KM, Alshayeb AF, Deghedy A. HCV RNA in peripheral blood mononuclear cells (PBMCs) as a predictor of the response to antiviral therapy in chronic hepatitis C. Alexandria J Med. 2014;50(4):317-22. [DOI:10.1016/j.ajme.2013.05.004]
27. Pawełczyk A, Kubisa N, Jabłońska J, Bukowska-Ośko I, Caraballo Cortes K, Fic M, et al. Detection of hepatitis C virus (HCV) negative strand RNA and NS3 protein in peripheral blood mononuclear cells (PBMC): CD3+, CD14+ and CD19+. Virol J. 2013;10(1):346. [DOI:10.1186/1743-422X-10-346] [PMID] [PMCID]
28. De Marco L, Gillio-Tos A, Fiano V, Ronco G, Krogh V, Palli D, et al. Occult HCV infection: an unexpected finding in a population unselected for hepatic disease. PloS One. 2009;4(12):e8128. [DOI:10.1371/journal.pone.0008128] [PMID] [PMCID]
29. Pham TNQ, Coffin CS, Michalak TI. Occult hepatitis C virus infection: what does it mean? Liver Int. 2010;30(4):502-11. [DOI:10.1111/j.1478-3231.2009.02193.x] [PMID]
30. Aboalam H, Rashed H-A, Mekky M, Nafeh H, Osman O. Prevalence of occult hepatitis C virus in patients with HCV-antibody positivity and serum HCV RNA negativity. Curr Med Res Pract. 2016;1(2):12-6. [DOI:10.4103/2357-0121.192539]
31. Yousif MM, Fakhr AE, Morad EA, Kelani H, Hamed EF, Elsadek HM, et al. prevalence of occult hepatitis c virus infection in patients who achieved sustained virologic response to direct-acting antiviral agents. Infez Med. 2018;26(3):237-43.
32. Abu Khadr NA, Nouh HH, Hanafi NF, Asser SL, Hussain YA. Secondary occult hepatitis C virus infection (HCV) in chronic HCV patients after treatment with sofosbuvir and daclatasvir. Int J Curr Microbiol App Sci. 2018;7(1):1357-65. [DOI:10.20546/ijcmas.2018.701.165]
33. Castillo I, Bartolomé J, Quiroga JA, Barril G, Carreño V. Diagnosis of occult hepatitis C without the need for a liver biopsy. J Med Virol. 2010;82(9):1554-9. [DOI:10.1002/jmv.21866] [PMID]
34. Cavalheiro Nde P, Filgueiras TC, Melo CE, Morimitsu SR, de Araújo ES, Tengan FM, et al. Detection of HCV by PCR in serum and PBMC of patients with hepatitis C after treatment. Braz J Infect Dis. 2007;11(5):471-4. [DOI:10.1590/S1413-86702007000500006] [PMID]
35. Radkowski M, Gallegos-Orozco JF, Jablonska J, Colby TV, Walewska-Zielecka B, Kubicka J, et al. Persistence of hepatitis C virus in patients successfully treated for chronic hepatitis C. Hepatology. 2005;41(1):106-14. [DOI:10.1002/hep.20518] [PMID]
36. Bernardin F, Tobler L, Walsh I, Williams JD, Busch M, Delwart E. Clearance of hepatitis C virus RNA from the peripheral blood mononuclear cells of blood donors who spontaneously or therapeutically control their plasma viremia. Hepatology. 2008;47(5):1446-52. [DOI:10.1002/hep.22184] [PMID]
37. Rahman MZ, Ahmed DS, Masud H, Parveen S, Rahman MA, Chowdhury MS, et al. Sustained virological response after treatment in patients with chronic hepatitis C infection--a five year follow up. Bangladesh Med Res Counc Bull. 2013;39(1):11-3. [DOI:10.3329/bmrcb.v39i1.15791] [PMID]
38. Sood A, Midha V, Mehta V, Sharma S, Mittal R, Thara A, et al. How sustained is sustained viral response in patients with hepatitis C virus infection? Indian J Gastroenterol. 2010;29(3):112-5. [DOI:10.1007/s12664-010-0006-3]

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Iranian Journal of Medical Microbiology

Designed & Developed by : Yektaweb | Publisher: Farname Inc