IN VITRO ANTIMICROBIAL EFFECT OF COLISTIN IN COMBINATION WITH MEROPENEM, FLUOROQUINOLONES AND TOBRAMYCIN AGAINST MULTIDRUG-RESISTANT PSEUDOMONAS AERUGINOSA ISOLATES
DOI:
https://doi.org/10.32782/2786-9067-2024-27-10Keywords:
Pseudomonas aeruginosa, colistin, fluoroquinolones, tobramycin, antibiotic synergismAbstract
The aim of the work was to study the effect of the combination of colistin with meropenem, fluoroquinolones and tobramycin on multidrug-resistent Pseudomonas aeruginosa isolates using different research methods. Methods. The object of the study was 30 multidrug-resistant P. aeruginosa isolates. Minimum inhibitory concentrations (MICs) of antimicrobials and its combinations were determined by the broth microdilution method (in Mueller-Hinton broth). The efficacy of the antimicrobial combination againts P. aeruginosa was evaluated using the chekerboard test. For two isolates the synergistic effect of antibiotic was investigated using the time-kill technique. Results. The combination of colistin+meropenem showed the synergistic effect against 43,3+ 9,1 %, combination of colistin+levofloxacin - against 40,0+8,9 % isolates, combinations of colistin+ciprofloxacin and colistin+tobramycin - 36,7+ 8,8 % and 30,0 + 8,4 % isolates, respectively. For the rest of isolates, combined effect of the drugs was additive. None of the tested isolates/antibiotic combinations exhibited antagonism. The time-kill technique for one colistin-susceptible and one resistant was used. For colistin-susceptible isolate the synergistik type of actions of the colistin+tobramycin and colistin+tobramycin combinations was confirmed by both methods. For colistin-resistant isolate action of antibiotic combinations was additive by chekerboard assay, and by using time-kill technique combination 0,5 MIC colistine+0,5 MIC tobramycine demonstrated moderate synergistic effect. Conclusion. The synergistic activity of combinations colistin with meropenem, with fluoroquinolones and with tobramycin for 30-43,3 % multidrug-resistant P.aeruginosa isolates and the possibility of inconsistent results by using different methods was shown.
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