مهار پمپ افالکس در سویه های کلینیکی سودوموناس آئروجینوزا با استفاده از سرترالین جهت شکست مقاومت باکتری به سیپروفلوکساسین.. (Persian)

Efflux Inhibition in Clinical Isolates of Pseudomonas Aeruginosa Using Sertraline for Ciprofloxacin Resistance Breakdown. (English)

Background and Aim: The efflux pump in Pseudomonas aeruginosa inhibits the effect of ciprofloxacin by releasing quinolones out of the cell. It is important to find compounds to inactivate or inhibit its activity to continue using the antibiotic. The present study aims to investigate using sertraline as an efflux pump inhibitor in P. aeruginosa to reduce the antibiotic resistance. Methods: Pseudomonas aeruginosa strains were isolated from clinical sources and were identified by routine microbiological methods. Resistance of the isolates to ciprofloxacin was evaluated by Kirby–Bauer test. Resistance breakdown was investigated by adding sertraline to the Moller Hinton agar medium and determining the zone of inhibition of ciprofloxacin. Minimum inhibitory concentration (MIC) by microplate dilution method and Minimum bactericidal concentration (MBC) by culture and MTT method were determined for the isolates and ATCC 27853. The presence of the efflux pump was evaluated by phenotypic method using sertraline and serial dilution method of liquid medium in microplate, on ciprofloxacin resistant strains. The presence of the producing gene of this pump was determined by genotyping method in resistant strains by performing PCR. The standard PAO1 strain of Pseudomonas aeruginosa was used as a positive control. Ethical Considerations :This study was approved by the Ethics Committee of the Faculty of Medical Sciences of Islamic Azad University of Brojerd (Code: IR.IAU.B.REC.1401.011). Results: Based on Kirby Bauer's results, three strains were considered resistant to ciprofloxacin. MIC of drug-resistant strains was between 32 and 64 mg/ml and MBC was between 16 and 32 mg/ml. By performing electrophoresis on the PCR products, it was determined that the tested strains contain the mexA gene encoding the efflux pump. In the agar medium without sertraline, the zone of inhibition of around the ciprofloxacin disc was zero, but after adding sertraline, the diameter of the halo increased to 25 mm.The minimum inhibitory concentration of ciprofloxacin in the isolates before adding 25 micrograms of sertraline was 128 micrograms/ml and after adding sertraline, it was 4 micrograms/ml. Conclusion: It was concluded that sertraline inhibited the efficiency of the efflux pump in resistant P. aeruginosa isolates and reduced ciprofloxacin resistance. [ABSTRACT FROM AUTHOR]

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