Comparative Evaluation of In-vitro Synergy Testing Methods in Carbapenem-Resistant Acinetobacter Species

Year 2019, , 23 - 33, 15.03.2019

Ranu Soni Varsha Gupta Priya Datta Satinder Gombar Jagdish Chander

https://doi.org/10.5799/jmid.537162

Abstract

Objective: There is an increasing incidence of Acinetobacter species causing serious
hospital acquired infections such as blood stream infections (BSI), catheter
associated urinary tract infections (CAUTI) and lower respiratory tract
infections(LRTI) with high mortality rate of 30-75% in patients having long
hospital stay especially in critical care units (CCUs). During the past decade,
multi drug resistant Acinetobacter
isolates have presented a real challenge to clinicians and are posing
difficulties in treatment. Carbapenem-resistant Acinetobacter species particularly A. baumannii, represent a growing public health concern, since they
often confer resistance to other critically important antimicrobials.

Methodology: In the present study, various antibiotic combinations
such as colistin + meropenem, imipenem + tigecycline, polymyxin B +
azithromycin and doripenem + sulbactam are used for MDR Acinetobacter infections and tested for in-vitro combination test
by Epsilometric test and Broth Micro dilution and confirmation done by time
kill assay.

Results: We found synergistic results with all three methods
used in study with three combinations significantly (p<0.05) but with one
combination i.e. doripenem+sulbactam, synergy found only with Etest not with
MCB and time kill assay (p~0.069).  

Conclusions: We have also observed
and compared outcome of the patients with respect to the treatment received
during hospital stay, but we did not found significant difference between two
groups, (two drug regimen & three drug regimen) regarding their mortality.  J
Microbiol Infect Dis 2019; 9(1): 23-33.

Keywords

Acinetobacter species, drug synergism, antibiotic sensitivity testing

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