Theraputic Effects of Bactriophage alone and in combination With Meropenem on Multi drug resistanace Escherichia coli in vitro study

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Shaymaa Nasif jassim, Dr. Abudl Kareem Hameed Abd

Abstract

Back ground: One of the most deadly infectious disease pathogens, Escherichia coli (E.coli) is a gram-negative (Gr-ve), rod-shaped, facultative anaerobe bacterium. E.coli phages are bacterial viruses that infect bacteria and can replicate in one of two ways: the lytic life cycle or the lysogenic life cycle. The majority of E.coli isolates are multi-drug resistant (MDR), making it difficult to treat their infections. Combination of antibiotics & phages, is a good option for addressing this issue.


Aims of the study:  This study aims to assess the efficacy of bacteriophage activity as an antibacterial agent alone and in combination with antibiotics against MDR E. coli and to identify antibacterial combinations with synergistic effects for the treatment of MDR.


 Materials and Methods: From April to June 2022, 39 isolates were collected from patients with urinary tract infections who were treated at the Medical City of Al-Imamain Al-Khadimain  in Baghdad .They were identified with the help of morphological characteristics and the VITEK2 compact system. Phages were isolated from different regions in Baghdad city including (soil, sewage, irrigation channels).


Results: In this study, E.coli were isolated from urinary tract infection patients. E.coli isolates were the most prevalent (36.8%), followed by Enterococcus feacalis (24.5%).Distribution by gender reveals a higher percentage of females than males. The percentages of resistant isolates to the antibiotics tested were high resistant rate to Trimethoprim/sulphamathaxozole , ceftriaxone, while low resistant  to carbapenem group & nitrofurantion. From 39 isolates, 32 were MDR, 6 were XDR, and 1 was PDR. The combination of phage with 1/4 or 1/2 MIC of each of meropenen, nitrofurantion and trimethoprim/sulphamethoxazole for 1,11,36 isolates resulted in synergist effects to the antibiotics against MDR E. coli strains obtained in this study.


Conclusions: Isolates of E. coli are highly susceptible to Imipenem, Meropenem, Ertapenem, and nitrofurantion antibiotics, but highly resistant to trimethoprim/sulfamethoxazole and cephalosporins. Most combinations of meropenem, with phage exhibited highly synergistic effects against MDR E. coli strains and decreased resistance.

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