Akademik Veri Yönetim Sistemi
Ankara Üniversitesi Tıp Fakültesi Mecmuası, cilt.75, sa.1, ss.28-35, 2022 (Hakemli Dergi)
Objectives: Increasing resistance to antibacterial drugs in gram-negative bacteria isolated from the community and especially from the hospital has become one of the most important health problems both in the world and in our country. Acinetobacter genus and Enterobacteriacea family have an important place among gram-negative bacteria with increased antibacterial drug resistance. In this study, we aimed to evaluate the in vitro effects of various antibiotic combinations with E-test method and determine synergistic effective combinations that could be used in multidrug resistant Acinetobacter baumannii infections and ESBL and carbapenemase secreting gram-negative enteric bacterial infections. Materials and Methods: It was evaluated whether the combinations of colistin with trimethoprim-sulfamethoxazole, rifampicin, doxycycline, sulbactam, imipenem, tigecycline and chloramphenicol were synergistic effective in vitro in 20 colistin-susceptible but multidrug-resistant, 20 colistin- and multi-drug-resistant Acinetobacter baumannii strains and 20 both extended-spectrum beta-lactamase and carbapenemase-producing Klebsiella pneumoniae strains isolated from various and different clinical samples (sputum, urine, tracheal aspirate, blood, etc.), sent from patients hospitalized in various clinics. Results: The synergistic effect was most common in the colistin-tigecycline combination in all multi-drug resistant bacterial groups, 80% in the colistin-sensitive Acinetobacter baumannii group, 45% in the colistin-resistant Acinetobacter baumannii group, and 80% in the Klebsiella pneumoniae group. Conclusion: Although further studies with more strains and different antibiotic combinations are needed for the appropriate treatment of infections due to multi-drug-resistant gram-negative bacteria, we found that colistin-tigecycline, colistin-sulbactam, colistin-rifampicin combinations are so effective for these strains in vitro and these results can help clinicians in treatment process.