Journal of Chemical and Pharmaceutical Research J. Chem. Pharm. Res., 2011, 3(4): 576-578 ISSN No: 0975-7384 CODEN(USA): JCPRC5 Comparisons of different antibiotics effect on the Acinetobacter baumannii by minimum inhibit concentration (MIC) method A. R. Reyhani Yassavoli*1, Z. Bayat2 and A. Sadegian3 1Mostafa Khomeyni Hospital, Italy St, Tehran, Iran 2Department of Chemistry, Islamic Azad University -Quchan Branch, Iran 3Mashhad University Medical Science MUMS –Gaem Hospital, Mashhad, Iran
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ABSTRACT This study is comparison of different antibiotics effect on the Acinetobacter baumannii by minimum inhibit bacter(MIC) method1.2. This microrganism detected from a 16 year young old patient that his right medial malleolous bone was fractured in a car accident with total and severe shin skin defect. The patient wound was infected by Acinetobacter and there was not any response to primary &secondary antimicrobial management. We assessed and recorded minimum inhibit bacter(MIC) on the many kinds of antibiotics included : Imipenem ,Ciprofloxacin ,Ceftazidim ,Ceftiriaxon,and Amikacin ; that recommended by orthopedic surgery team . Our comparative analysis reveals a highly threshold resistance to MIC in all antibiotics except Amikacin,incontrast of the past culture in new antibiogram we find sensitivity to tetracycline therefore the patient in a weekly attack period by taking 30 million crystal penicillin/12h/iv,1.5 gr amikacin/12h,/iv,200mg doxiciclin /12h/p.o treated successfully. ______________________________________________________________________________ INTRODUCTION In recent years Acinetobacter baumannii is important from many views. The first of course not the most important t; it is one of hospital infection and occurred especially in intensive care units .at this wards ,there is serious statements for patient in treatment period that challenging to this bacteri could be dangerous.3-6
The second; Multidrug-resistant Acinetobacter baumannii is associated with a wide spectrum of infectious diseases ranging from nosocomial, community-acquired infections7-9to those acquired following war or natural disaster, Especially to military personnel with war wounds, Acinetobacter infection is a formidable threat2. The treatment has become exceedingly difficult,
A. R. Reyhani Yassavoli et al J. Chem. Pharm. Res., 2011, 3(4):576-578 ______________________________________________________________________________
not only because the bacterium can develop extensive antimicrobial resistance but because it also forms biofilms that are resistant to host defense and antimicrobial treatment.this resistanc could be genetically or inherent induce.3,7,9, 10,11,12 The third; this bacteri not only in hospital patient, war and natural disaster is important but also it is important in body defense barrier broke patient. (eg.cyctic fibrosis, immune deficiency ,neutropenia) 9-14 Attention to previous paragraph tell us Acinetobacter baumannii distribute in world with all of its difficulty .unfortunately most of study have been shown resistanc to often antimicrobial agent(eg: ampicillin, amoxicillin, clauvonic acid,anti staphilococcy penicillin,cephallosporins generation except ceftazidim ,tetracicllin,macrolids, rifampin, and choloramphinecol)8,10-14 Ayan and et al over an 18 month period, the bacteriological, clinical and epidemiological characteristics of nosocomial Acinetobacter baumannii infections have been studied in a teaching hospital5. Typing studies were performed on 38 strains isolated from 36 patients. Twenty-two of the strains were isolated during the three outbreaks. Surgery, catheterization, mechanical ventilation, and antibiotic therapy for adult patients and respiratory distress syndrome, mechanical ventilation, and prematurity for paediatric patients were the main risk factors identified2-10. All isolates were resistant to penicillins (except ampicillin-sulbactam), cephalosporins, Gentamicin, and Aztreonam but susceptible to Carbapenems and Colistin. Resistance
Sulfamethoxazole, and Amikacin was variable. Antibiotyping, arbitrarily-primed polymerase chain reaction (AP-PCR) and the pulse-field gel electrophoresis (PFGE) indicated the epidemiological relationship8. The outbreak strains, demonstrated genetic distinction between our three outbreaks and isolates from specific
EXPERIMENTAL SECTION
After the patient was admitted ,we beginning different empirical antibiotics contain :Cephalotin,Vancomycin ,Clindamycin,Metronidazol and Imipenem but this attempting don’t any result. Acinetobacter baumannii and antrobacter detected from wound culture. antibiogram result s for Acinetobacter baumannii was resistanted.we cant acquired optimal response by Debridement &irrigation of wound in control of the infection in contrast to this statement granulation tissue well growth and everything prepare to skin graft except infection control .The last antibiotic therapy dose was included:Vancomycin2gr/q 12h, Metronidazol 500mg/q8h ,Clindmicin600mg/q6 h without any response to treatment . Finally, we send our sample to new libratory for MIC and result recorded16 .
RESULTS AND DISCUSSION
Cultured bacteria MIC for Imipenem, Ciprofloxacin, Ceftazidim, Ceftiriaxon and Amikacin assessed to consist of:
Antibiotics Concentration Microgram/mi Threshold of resistance Microgram/mi Imipenem Ciprofloxacin Ceftazidim Ceftiriaxon Amikacin A. R. Reyhani Yassavoli et al J. Chem. Pharm. Res., 2011, 3(4):576-578 ______________________________________________________________________________
Attack management began by Penicillin 30 million unit/q12h/iv ,Amikacin1.5 gr /q12h/iv , Doxicicllin200mg/po and local Penicillin . The Renal and sense of hearing control checked and thus we have an acceptable cure in my patient. After one week drug regime dosage was reduced to Amikacin 500 mg/q12h ,Penicillin 5 milion unit/q6h,Doxicicllin200mg /q12h/p.o
CONCLUSION
Our comparative analysis reveals a highly threshold resistance to MIC in all antibiotics except Amikacin ,according to this finding , attention to MIC for using in difficult management due to resistant micro organisms may be helpful17.
REFERENCES
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