Propranolol, chlorpromazine and diclofenac restore susceptibility of extensively drug-resistant (XDR)-Acinetobacter baumannii to fluoroquinolones

Autor: Khaled M. Aboshanab, Mohammad M. Aboulwafa, Bahaa E. Anwer, Mostafa Ahmed Mohammed, Mohammed T. Ahmed
Rok vydání: 2020
Předmět:
0301 basic medicine
Acinetobacter baumannii
Nosocomial Infections
Drug resistance
Levofloxacin
Geographical Locations
Medical Conditions
Ciprofloxacin
Disk Diffusion Antimicrobial Tests
Antibiotics
Drug Resistance
Multiple
Bacterial
Medicine and Health Sciences
Cross Infection
Multidisciplinary
biology
Antimicrobials
Drugs
Drug Synergism
Antimicrobial
Propranolol
Anti-Bacterial Agents
Drug Combinations
Infectious Diseases
Amikacin
Doxycycline
Medicine
Engineering and Technology
Egypt
medicine.drug
Acinetobacter Infections
Fluoroquinolones
Research Article
Biotechnology
Diclofenac
Asia
Catheters
Chlorpromazine
Science
030106 microbiology
Bioengineering
Microbiology
03 medical and health sciences
Antimalarials
Microbial Control
medicine
Humans
Pharmacology
business.industry
Biology and Life Sciences
Acinetobacter
biology.organism_classification
030104 developmental biology
Antibiotic Resistance
People and Places
Africa
Colistin
Medical Devices and Equipment
Antimicrobial Resistance
business
Zdroj: PLoS ONE
PLoS ONE, Vol 15, Iss 8, p e0238195 (2020)
ISSN: 1932-6203
Popis: Nosocomial infections caused by extensively drug-resistant (XDR) or Pan-Drug resistant (PDR) Acinetobacter (A.) baumannii have recently increased dramatically creating a medical challenge as therapeutic options became very limited. The aim of our study was to investigate the antibiotic-resistance profiles and evaluate the various combinations of ciprofloxacin (CIP) or levofloxacin (LEV) with antimicrobial agents and non-antimicrobial agents to combat antimicrobial resistance of XDR A. baumannii. A total of 100 (6.25%) A. baumannii clinical isolates were recovered from 1600 clinical specimens collected from hospitalized patients of two major university hospitals in Upper Egypt. Antimicrobial susceptibility tests were carried out according to CLSI guidelines. Antimicrobial susceptibility testing of the respective isolates showed a high percentage of bacterial resistance to 19 antimicrobial agents ranging from 76 to99%. However, a lower percentage of resistance was observed for only colistin (5%) and doxycycline (57%). The isolates were categorized as PDR (2; 2%), XDR (68; 68%), and multi-drug resistant (MDR) (30; 30%). Genotypic analysis using ERIC-PCR on 2 PDR and 32 selected XDR isolates showed that they were not clonal. Combinations of CIP or LEV with antibiotics (including, ampicillin, ceftriaxone, amikacin, or doxycycline) were tested on these A. baumannii non-clonal isolates using standard protocols where fractional inhibitory concentrations (-FICs) were calculated. Results of the respective combinations showed synergism in 23.5%, 17.65%, 32.35%, 17.65% and 26.47%, 8.28%, 14.71%, 26.47%, of the tested isolates, respectively. CIP or LEV combinations with either chlorpromazine (CPZ) 200 μg/ml, propranolol (PR) in two concentrations, 0.5 mg/ml and 1.0 mg/ml or diclofenac (DIC) 4 mg/ml were carried out and the MIC decrease factor (MDF) of each isolate was calculated and results showed synergism in 44%, 50%, 100%, 100% and 94%, 85%, 100%, 100%, of the tested isolates, respectively. In conclusion, combinations of CIP or LEV with CPZ, PR, or DIC showed synergism in most of the selected PDR and XDR A. baumannii clinical isolates. However, these combinations have to be re-evaluated in vivo using appropriate animal models infected by XDR- or PDR- A. baumannii.
Databáze: OpenAIRE
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