Resistance to carbapenems and investigation of the synergistic effect based on minocycline under concession of Acinetobacter baumannii
Acinetobacter baumannii; Acinetobacter infections; Resistance; Carbapenems; synergism, antimicrobial combination.
Acinetobacter baumannii is an important pathogen associated with health-related infections,especially in intensive care units. Hospital storms caused by carbapenem-resistant A. baumannii (CRAB) have been provided worldwide. Away from the rapid ability of this pathogen to acquire the mechanism of resistance to antimicrobials and the new treatment options, an association between different antimicrobials that were used as a strategy to improve an effective herd, especially in obtaining multidrug-resistant drugs (MDR). In this context, minocycline was identified as an option in therapeutic changes by A. baumannii due to its favorable safety profile, its ability to overcome various mechanisms of bacterial resistance and in vitro activity against A. baumannii MDR strains. This work aims to expand the knowledge of the context of bacterial resistance and to evaluate the in vitro activity of minocycline-based antimicrobial associations under CRAB concession. The guests, coming from hospitalized patients, had the profiles of susceptibility to antimicrobials determined and investigated the possible multifaceted activities of minocycline with meropenem, ciprofloxacin, polymyxin B and colistin (polymyxin E). All levels reinforced at a high level for carbapenems and ciprofloxacin. Polymyxin B, in turn, was the antimicrobial for which there was a higher percentage of susceptibility (91.3%) and, consequently, the one with the highest potency (MIC 50: 1 μg / mL). Synergism between miniocycline and meropenem was observed in most cases and the indifferent or antagonistic effect was observed mainly for an association between minocycline and polymyxins. This study showed that the association of a carbapenemic (meropenemic) with minocycline may be a strategy for the treatment of drugs by CRAB and, despite the high resistance to antimicrobials, observing the pathogens, a high susceptibility to polymyxin B.