Synergistic Effect of Probiotic Bacteria and Antibiotics on Antibiotic-resistant Strains of Pseudomonas Aeruginosa Isolated from Patients with Burn Wounds

Background: Burn infections are one of the leading causes of death in the world. Antibiotic resistance is a major concern among the medical community. In this study, we investigated the effect of common probiotic strains on multidrug-resistant Pseudomonas aeruginosa strains. Methods: Strains of Pseudomonas aeruginosa from burn wounds of patients were isolated. Then pathogens were biochemically identified and their antibiotic resistance pattern against imipenem, gentamycin, ciprofloxacin, tetracycline and chloramphenicol were examined. Susceptibility of multidrug-resistant pathogens to 5 commercial and 5 native strains of probiotics were investigated using disc diffusion method. The probiotic strain, with the highest anti-pathogen activity was tested either alone or in combination with five previously tested antibiotics.    Results: The Lactobacillus plantarum 299V strain showed the highest inhibitory effect against the antibiotic-resistant Pseudomonas aeruginosa pathogens compared to the other probiotic strains. In most isolates, probiotic alone, had a higher mean diameter of growth inhibition zone compared to the combination with antibiotics, except for tetracycline antibiotic, which is synergistic with probiotic bacteria and has the highest anti-pathogenic properties (P <0.001). Conclusion: According to the results of this study, Lactobacillus plantarum can be used as an adjunct in the treatment of antibiotic-resistant bacterial infections in the treatment of burn wounds.