title: Investigating the in vitro synergistic activities of several antibiotic combinationsagainst carbapenem-resistant Acinetobacter baumannii isolates.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Among the tested antimicrobial combinations, the in vitro combination of MEM with TGC or CST was most effective against the CR A. baumannii strains.
authors: Department of Infectious Diseases and Clinical Microbiology, Kelkit State Hospital, Gümüşhane, Turkey.
authors: Sevim
authors: S
authors: Yavaş
authors: Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors: Meltem Arzu
authors: MA
authors: Yetkin
authors: Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors: Bircan
authors: B
authors: Kayaaslan
authors: Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors: Aliye
authors: A
authors: Baştuğ
authors: Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors: Halide
authors: H
authors: Aslaner
authors: Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors: Ayşe
authors: A
authors: But
authors: Infection Control Commitee, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors: Dilek
authors: D
authors: Kanyilmaz
authors: Department of Medical Microbiology and Clinical Microbiology, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors: Berrin
authors: B
authors: Sari
authors: Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors: Esragül
authors: E
authors: Akinci
authors: Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors: Hürrem
authors: H
authors: Bodur
mesh_terms: D000151:Acinetobacter Infections; D040981:Acinetobacter baumannii; D000900:Anti-Bacterial Agents; D024901:Drug Resistance, Multiple, Bacterial; D004357:Drug Synergism; D006801:Humans; D008826:Microbial Sensitivity Tests
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acinetobacter baumannii; E-test method; drug resistance; synergy test