Kazemian Hossein, Karami-Zarandi Morteza, Heidari Hamid, Ghanavati Roya, Khoshnood Saeed
Clinical Microbiology Research Center Ilam University of Medical Sciences Ilam Iran.
Department of Microbiology, Faculty of Medicine Ilam University of Medical Sciences Ilam Iran.
Health Sci Rep. 2024 Apr 29;7(5):e2061. doi: 10.1002/hsr2.2061. eCollection 2024 May.
Emergence of multidrug resistance in non-fermenting Gram-negative bacilli is a threat to public health. Combination therapy is a strategy for the treatment of antibiotic-resistant infections.
In this cross-sectional study, a total of 63 nonduplicate clinical isolates of and were collected from various specimens. Identification of bacterial isolates was performed by phenotypic and molecular tests. Antibiotic susceptibility patterns and detection of β-lactamase genes were determined using the broth microdilution and polymerase chain reaction (PCR) techniques, respectively. Then, the combined effects analysis was determined by the checkerboard method. Based on the status of resistance to carbapenems (imipenem and meropenem), 25 isolates of each genus were selected for further investigation.
For , , and genes were positive in 21 (84%), 17 (68%), and 11 (44%) of isolates, respectively. In isolates, was the most common gene (44%) and other genes including , , and were found in nine (36%), six (24%), and three (12%) isolates, respectively. Meropenem (MER)-tigecycline (TIG) had a significant synergistic effect against 20 (80%) ( value < 0.001). This combination was also efficient against 5 (20%) isolates. Moreover, the other combination, tigecycline-amikacin (TIG-AMK) was effective against 10 (40%) isolates. The combination of colistin (COL) and MER showed a significant synergistic effect against 21 (84%) ( value < 0.001) and 17 (68%) isolates ( value < 0.001).
The MER-TIG and COL-MER combinations are promising options against resistant bacteria. Our study could be helpful for the development of a new treatment recommendation.
非发酵革兰氏阴性杆菌中多重耐药性的出现对公众健康构成威胁。联合治疗是治疗抗生素耐药性感染的一种策略。
在这项横断面研究中，从各种标本中总共收集了63株非重复的临床分离株。通过表型和分子试验对细菌分离株进行鉴定。分别使用肉汤微量稀释法和聚合酶链反应（PCR）技术测定抗生素敏感性模式和β-内酰胺酶基因检测。然后，通过棋盘法进行联合效应分析。根据对碳青霉烯类（亚胺培南和美罗培南）的耐药情况，从每个属中选择25株分离株进行进一步研究。
对于[具体细菌名称1]，[具体基因1]、[具体基因2]和[具体基因3]基因在分别21株（84%）、17株（68%）和11株（44%）分离株中呈阳性。在[具体细菌名称2]分离株中，[具体基因4]是最常见的基因（44%），其他基因包括[具体基因5]、[具体基因6]和[具体基因7]分别在9株（36%）、6株（24%）和3株（12%）分离株中被发现。美罗培南（MER）-替加环素（TIG）对20株（80%）[具体细菌名称1]具有显著的协同作用（P值<0.001）。该联合用药对5株（20%）[具体细菌名称2]分离株也有效。此外，另一种联合用药，替加环素-阿米卡星（TIG-AMK）对10株（40%）[具体细菌名称2]分离株有效。黏菌素（COL）和美罗培南的联合用药对21株（84%）[具体细菌名称1]（P值<0.001）和17株（68%）[具体细菌名称2]分离株（P值<0.001）显示出显著的协同作用。
MER-TIG和COL-MER联合用药是对抗耐药菌的有前景的选择。我们的研究可能有助于制定新的治疗建议。
