Investigating the in vitro synergistic activities of several antibiotic combinationsagainst carbapenem-resistant Acinetobacter baumannii isolates.

Abstract

Acinetobacter baumannii (A. baumannii) is one of the most common healthcare-associated infectious agents worldwide. The aim of this study was to investigate the in vitro synergistic activities of several antibiotic combinations against carbapenem-resistant (CR) A. baumannii isolates. Eighteen CR A. baumannii strains were isolated from the patients who were hospitalized in the intensive care unit between June 2012 and August 2012. The in vitro effects of single and binary combinations of meropenem (MEM), colistin (CST), tigecycline (TGC), and sulbactam (SUL) on these isolates were determined using the Epsilometer test (E-test) method. All 18 isolates were resistant to MEM and SUL and susceptible to CST. TGC was detected as susceptible in two of the isolates and intermediate susceptibility results were observed in the remaining isolates. With MEM-CST and MEM-TGC combinations, synergism was determined against all isolates. The synergistic and/or additive effect ratios were detected in MEM-SUL, CST-SUL, TGC-SUL, and CST-TGC combinations as 16.7%, 38.9%, 16.7%, and 5.6%, respectively. Among the tested antimicrobial combinations, the in vitro combination of MEM with TGC or CST was most effective against the CR A. baumannii strains.