title: Efficacy of sulbactam and its combination with imipenem, colistin and tigecycline in an experimental model of carbapenem-resistant Acinetobacter baumannii sepsis.
abstract: BACKGROUND
  In recent years, multidrug-resistant Acinetobacter baumannii has been reported as an important nosocomial pathogen, and treatment options are limited. The aim of this study was to investigate the additional effect of sulbactam on monotherapy with colistin, tigecycline and imipenem in experimental sepsis with carbapenem-resistant A. baumannii in mice.
  
  
  METHODS
  Sepsis was developed in 8- to 10-week-old BALB/c mice by an intraperitoneal injection of A. baumannii. Antibiotic was given intraperitoneally 2 h after bacterial inoculation. Each experimental group had 15 mice and was divided into 3 subgroups. Mice were sacrificed at 24, 48 or 72 h. Lung, liver, heart and spleen samples were cultured, and homogenates of lung and liver were used to detect the number of colony-forming units per gram. Bacterial clearance was compared in lung and liver at different time points.
  
  
  RESULTS
  Imipenem did not decrease the bacterial load, but the other antibiotics showed significant bactericidal activity compared with the control group, and the combination of imipenem with sulbactam decreased the bacterial load in lung and liver. However, the addition of sulbactam to colistin and tigecycline had no significant effect on bacterial counts. Only the addition of sulbactam to imipenem showed better bactericidal activity compared to imipenem alone.
  
  
  CONCLUSIONS
  These results suggested that combining sulbactam with tigeycline or colistin does not increase the efficiency of these antibiotics.
authors: Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Gokcen
authors: G
authors: Dinc
authors: Hayati
authors: H
authors: Demiraslan
authors: Ferhan
authors: F
authors: Elmali
authors: Salman Shaheer
authors: SS
authors: Ahmed
authors: Gokhan
authors: G
authors: Metan
authors: Emine
authors: E
authors: Alp
authors: Mehmet
authors: M
authors: Doganay
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology*; D058491:Bacterial Load / Q000187:drug effects; D015780:Carbapenems / Q000494:pharmacology; D003091:Colistin / Q000008:administration & dosage / Q000494:pharmacology; D004195:Disease Models, Animal; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage / Q000494:pharmacology; D051379:Mice; D008807:Mice, Inbred BALB C; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000494:pharmacology; D018805:Sepsis / Q000188:drug therapy* / Q000382:microbiology; D013407:Sulbactam / Q000008:administration & dosage / Q000494:pharmacology; D000078304:Tigecycline; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D000078304:Tigecycline; D015378:Imipenem; D008911:Minocycline; D013407:Sulbactam; D003091:Colistin