Effect of Imipenem and Amikacin Combination against Multi-Drug Resistant Pseudomonas aeruginosa

Abstract

Pseudomonas aeruginosa is an opportunistic nosocomial pathogen associated with high morbidity and mortality rates. Combination of antibiotics has been found to combat multi-drug resistant or extensively drug resistance P. aeruginosa. In this study we investigate the in vitro and in vivo effect of amikacin and imipenem combination against resistant P. aeruginosa. The checkerboard technique and time-killing curve have been performed for in vitro studies showed synergistic effect for combination. A peritonitis mouse model has been used for evaluation of the therapeutic efficacy of this combination which confirmed this synergistic effect. The in vitro and in vivo techniques showed synergistic interaction between tested drugs with fractional inhibitory concentration indices (FICIs) of ≤0.5. Conventional PCR and quantitative real-time PCR techniques were used in molecular detection of bla IMP and aac(6′)-Ib as 35.5% and 42.2% of P. aeruginosa harbored bla IMP and aac(6′)-Ib respectively. Drug combination viewed statistically significant reduction in bacterial counts (p value < 0.5). The lowest bla IMP and aac(6′)-Ib expression was observed after treatment with 0.25 MIC of imipenem + 0.5 MIC of amikacin. Morphological changes in P. aeruginosa isolates were detected by scanning electron microscope (SEM) showing cell shrinkage and disruption in the outer membrane of P. aeruginosa that were more prominent with combination therapy than with monotherapy.

Evaluation of the Synergistic Antimicrobial activity of Amikacin with Norfloxacin against Pseudomonas aeruginosa isolated from buffaloes clinical mastitis

“…Moreover, the MIC for amikacin and nor oxacin is signi cantly reduced from 64 µg/mL to 1 µg/mL and from 256 µg/mL to 8µg/mL respectively with FIC index 0.25 as showed in table (4). This was in contact with previous studies (Farhan et al, 2021) described the synergism and the antimicrobial activity between Imipenem and amikacin in the treatment of multi drug resistant P. aeruginosa isolates.…”

“…Traditional PCR and quantitative real-time PCR practices were e ciently applied for the detection of the P. aeruginosa harbored the resistance genes bla IMP and aac(6)-Ib as well as genotyping of P. aeruginosa isolates may be grouped with multiple locus variable-number-tandem repeat analysis (MLVA) to determine the relationship and similarities between strains (Farhan et al, 2021;Schauer et al, 2021). The current study used mPCR for the detection of some virulence genes of P. aeruginosa isolates through successful ampli cation of exoT, toxA, oprL, and iasI genes at 152, 396, 504, 606 bp respectively as well as the antibiotics resistant genes for aminoglycosides and uoroquinolones antibiotics; qnrS, qnrA and aadB at 417, 516 and 319 bp respectively as in Fig.…”

Emergence of NDM-1–producing Pseudomonas aeruginosa Sequence Type 773 Clone: Shift of Carbapenemase Molecular Epidemiology and Spread of 16S rRNA Methylase Genes in Korea

“…The combination of carbapenem and amikacin has become an important treatment option to combat multidrug-resistant or extensively drug-resistant P. aeruginosa [ 13 ]. In a previous report, NDM-1–producing P. aeruginosa isolates had the highest sensitivity to tigecycline and amikacin [ 14 ].…”

The comparative effects of erythromycin and amikacin on acute respiratoryPseudomonas aeruginosainfection

“…In addition, Farhan et al (2021) evaluated the efficacy of combining amikacin with imipenem against resistant P. aeruginosa in vitro and in vivo. They found that the combination was superior (Farhan et al, 2021). The results of this study were in opposition to their results.…”