ANTİVİRAL İLAÇLARIN HASTANE ENFEKSİYON ETKENİ PSEUDOMONAS AERUGINOSA ÜZERİNDE SİNERJİSTİK ETKİSİNİN ARAŞTIRILMASI

Öz

Amaç: Yaygın hastane enfeksiyon ajanı olan Pseudomonas aeruginosa (P. aeruginosa)’ nın tedavisi amacıyla antiviral ilaçlar ile antibiyotiklerin kombinasyon olarak kullanılmaları sonucunda oluşan sinerjistik etkinliğinin araştırılması amaçlanmıştır.

Gereç ve Yöntem: Antiviral ilaçların etken maddesi olarak Umifenovir (UMF) ve Ribavirin (RBV)i antibiyotiklerden kolistin ve beta laktamaz inhibitörü sulbaktam ile çalışılmıştır. Çok İlaca Dirençli (ÇİD) ve Kolistin (KOL) dirençli P. aeruginosa klinik izolatları çalışmaya dahil edilmiştir. P. aeruginosa üzerinde, UMF ve RBV’ nin ayrı ayrı Minimal İnhibisyon Konsantrasyonu (MİK) mikrodilüsyon yöntemi ile, KOL ve Sulbaktam (SUL) ile sinerjistik etkinliğine ise dama tahtası sinerji testi ile araştırılmıştır.

Sonuç ve Tartışma: Dirençli suşlarda, RBV ile KOL ve SUL kombinasyonlarında sinerji ve kısmi sinerji oluşurken (FİK = 0.375-0.75), ATCC 27853 suşu ile yapılan çalışmada indeferans ve aditif (FİK=1.0-2.0) etkileşimin daha yoğun olduğu görülmüştür. UMF ile KOL ve SUL kombinasyonlarında ise sinerji ve kısmi sinerjiler (FİK=0.53-0.75) dikkat çekerken, ATCC 27853 suşlarında aditif (FİK=1.0) etki tespit edilmiştir. Sonuçlar değerlendirildiğinde UMF ve RBV’ nin KOL ve SUL ile kombinasyon kullanımlarının dirençli suşlar üzerinde daha etkin olduğu görülmüş olup, kombinasyonların dirençli hastane enfeksiyon etkenlerinin tedavisinde alternatif bir seçenek olarak kullanılabilirliği fikri gelecek çalışmalarla desteklenmelidir.

Anahtar Kelimeler

• Antibiyotik direnci
• antiviral ilaç
• Pseudomonas aeruginosa
• dama tahtası
• sinerji

INVESTIGATION OF THE SYNERGISTIC EFFECT ON THE HOSPITAL INFECTION AGENT PSEUDOMONAS AERUGINOSA OF ANTIVIRAL DRUGS

Öz

Objective: It was aimed to investigate the synergistic efficacy of antiviral drugs and antibiotics in combination for the treatment of Pseudomonas aeruginosa (P. aeruginosa), which is a common nosocomial infection agent.

Material and Method: Umifenovir (UMF) and Ribavirin (RBV) antibiotics as active ingredients of antiviral drugs, colistin and beta-lactamase inhibitor sulbactam were studied. Multi-Drug Resistant (MDR) and Colistin (COL) resistant P. aeruginosa clinical isolates were included in the study. On Pseudomonas aeruginosa, the minimal inhibition concentration of UMF, RBV, KOL and SUL separately with the microdilution method, and the synergistic activity of UMF -RBV and KOL- Sulbactam (SUL) were examined with the checkerboard synergy test.

Result and Discussion: In resistant strains, synergy and partial synergy occurred in combinations of RBV with COL and SUL (FIC = 0.375-0.75), whereas in the study conducted with ATCC 27853 strain, inferential and additive (FIC = 1.0-2.0) interactions were observed to be more intense. While synergy and partial synergies (FIC=0.53-0.75) were noted in combinations of UMF with KOL and SUL, an additive effect (FIC=1.0) was detected in ATCC 27853 strains. When the results were evaluated, it was seen that the use of UMF and RBV in combination with KOL and SUL was more effective on resistant strains, and the idea that the combinations could be used as an alternative option in the treatment of resistant nosocomial infections should be supported by future studies.

Anahtar Kelimeler

• Antibiotic resistance
• antiviral drug
• checkerboard
• Pseudomonas aeruginosa
• synergy

Kaynakça

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