Efficacy of Amikacin and Imipenem Against Multi-Drug Resistant Gram-Negative Bacteria Isolated From Wound Infections
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Abstract:
Background and Objective: 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. Aims: 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. Methods: Gram-negative bacteria were collected from wound swabs streaked on various media. 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: E. 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%), Acinetobacter 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 showed synergistic effect against the tested Gram-negative bacteria which can help in the control and treatment of serious wound infections.
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Journal title
volume 17 issue 2
pages 11- 11
publication date 2023-03
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