Sains Malaysiana 44(7)(2015): 1061–1065
Interaction
of Imipenem and Tigecycline against Carbapenem-Resistant Acinetobacter
baumanii: The Relativity of Synergism
(Interaksi
Imipenem dan
Tigecycline terhadap Rintang-Carbapenem Acinetobacter
baumanii: Kerelatifan
Sinergisme)
H. ALFIZAH1,
O.Z.
SITI
SARAH2
& M.Z. NORAZIAH2*
1Dept. of Medical
Microbiology & Immunology, Faculty of Medicine, Universiti
Kebangsaan Malaysia Medical Centre, Bandar Tun
Razak, 56000 Cheras, Kuala Lumpur,
Malaysia
2School of Diagnostic
and Applied Health Sciences, Faculty of Health Sciences
Universiti Kebangsaan Malaysia,
Jalan Raja Muda
Abd Aziz, 50300 Kuala Lumpur, Malaysia
Diserahkan: 26 Julai 2013/Diterima: 6 April 2015
ABSTRACT
Acinetobacter baumanii is an opportunistic bacterium that causes widespread
nosocomial infections and tends to be multi-resistant to most of
antibiotics. Tigecycline is a well-known
antibiotic that possesses a wide-range of activities and is very
active in vitro towards a variety of resistant pathogens,
including A. baumanii. The aim
of this study was to evaluate the effects of the imipenem
and tigecycline combination against carbapenem-resistant A. baumanii
(CRAB). The minimal inhibitory concentration (MIC)
was determined using the E-test method. The microbroth
checkerboard technique was employed to determine the effects of
the imipenem and tigecycline interaction
by obtaining the fractional inhibitory concentration (FIC)
index value. A time kill (TK) study was performed to identify any
synergistic effects when both imipenem
and tigecycline were used against CRAB strains.
The result demonstrated that all A. baumanni
strains exhibited imipenem MIC values
of 32 μg/mL. The combination of imipenem and
tigecycline demonstrated an additive effect
(FIC
> 0.5-4) against all of the strains and synergistic
activity (decrement of > 2 log10 CFU/mL) towards AC 34/07 and AC
32/06 strains. The use of imipenem
in combination with tigecycline resulted in a more efficient activity and an increased
capability to control CRAB infections. This effect showed
potential combination and may be of importance in the development
or modification of antimicrobial agents for the treatment of CRAB infections.
Keywords: Acinetobacter baumanii;
carbapenem-resistant; imipenem;
tigecycline
ABSTRAK
Acinetobacter baumanii adalah
bakteria oportunis
yang menyebabkan jangkitan nosokomial secara meluas dan cenderung
untuk menjadi
multirintang terhadap kebanyakan antibiotik. Tigecycline adalah antibiotik yang mempunyai pelbagai aktiviti dan sangat
aktif secara
in vitro terhadap pelbagai patogen rintang antibiotik, termasuklah A. baumanii. Tujuan kajian
ini adalah untuk menilai kesan
dan gabungan
antibiotik imipenem dan tigecycline terhadap A. baumanii rintang-karbapenem
(CRAB).
Kepekatan
perencatan minimum (MIC) ditentukan
dengan menggunakan
kaedah E-test. Teknik papan penyemak
mikrokaldu digunakan
untuk menentukan kesan imipenem dan interaksinya dengan tigecycline dengan mendapatkan nilai indeks kepekatan
rencatan berperingkat
(FIC).
Ujian masa membunuh
(TK)
telah dijalankan
untuk mengenal pasti kesan sinergi
apabila kedua-dua
imipenem dan tigecycline
digunakan terhadap
strain CRAB.
Hasil ujian
menunjukkan bahawa semua strain A. baumanni
memberi nilai
imipenem MIC sebanyak
32 μg/mL.
Gabungan imipenem dan tigecycline menunjukkan kesan tambahan (FIC> 0,5-4)
terhadap semua
strain yang diuji dan aktiviti
sinergi (pengurangan
sebanyak> 2 log10 CFU/mL) terhadap
strain AC 34/07 dan AC 32/06.
Penggunaan kombinasi
imipenem dan tigecycline
menghasilkan aktiviti
yang lebih cekap dan
meningkatkan kemampuan
untuk mengawal jangkitan CRAB. Kesan
ini menunjukkan
kombinasi yang berpotensi dan mungkin penting
dalam pembangunan
atau pengubahsuaian agen antimikrob untuk rawatan jangkitan
CRAB.
Kata kunci: Acinetobacter baumani;
imipenem I; rintang-karbapenem;
tigecycline
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*Pengarang untuk surat-menyurat; email: nora@medic.ukm.my
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