Value of E-test in the Determination of Synergistic Antimicrobial Combinations Active against Multi-Drug Resistant Enterobacteriacae

Abstract

ultidrug-resistant Enterobacteriaceae have been frequently reported from different parts of the world with the emergence of treatment problems. Antibiotics given empirically without proper antibiotic susceptibility testing are one of the major causes for the development of MDR. Multidrug-resistant Enterobacteriaceae infections are often caused by extended-spectrum b-lactamases (ESBLs) and carbapenemase-producing strains and represent an increasing global threat. Due to the high morbidity and mortality rates of MDR Enterobacteriacae infections, combination therapy, as opposed to monotherapy, are suggested. A synergistic effect may be developed when antibiotics are used in combination. Through this synergistic effect, treatment efficacy can be improved and resistance can be prevented. The aim of the present study was to determine the prevalence of multi-drug resistance among Enterobacteriacae and to compare between the E-test and the checkerboard titration method as rapid, in-vitro diagnostic tests that can help to determine the synergy between selected antimicrobial combinations thought to be active against multi-drug resistant Enterobacteriacae.