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In-vitro efficacy of fluoroquinolones and carbapenems against biofilm-forming and non-forming non-fermenting gram-negative bacteria isolated from clinical specimens

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May 06, 2025 version files 36.22 KB

Abstract

Non-fermenting gram-negative bacteria (NFGNB) pose a public health threat due to their tendency to cause multidrug-resistant and/or biofilm-associated infections. This cross-sectional study analyzed antibiograms, biofilm formation, and minimum inhibitory concentrations (MICs) of quinolones and carbapenems in NF-GNB from clinical specimens in a tertiary care hospital. Clinical specimens were processed for bacterial isolation and identification. Quinolone- and carbapenem-resistant Acinetobacter calcoaceticus-baumannii (ACB) complex and Pseudomonas aeruginosa, confirmed by disc diffusion, were tested for MICs of quinolones and carbapenems using broth microdilution. Biofilm formation was assessed by the microtiter plate method. Statistical analyses were performed in SPSS 17.0. A total of 92 NFGNB were isolated from patients (median age: 24 years, 56.52% female), primarily with urinary tract infections (40.23%). Biofilm formation was detected in 23.94% (17/71) of the ACB complex and 57.14% (12/21) of P. aeruginosa. For P. aeruginosa, the MIC50 against norfloxacin was 8 µg/ml in biofilm non-formers and ≥64 µg/ml in formers, while ≥0.5 µg/ml and ≥1 µg/ml against ofloxacin, respectively. The MIC50 against ciprofloxacin was ≥32 µg/ml for ACB complex (both groups) and ≥4 µg/ml (non-formers) vs. ≥16 µg/ml (formers) for P. aeruginosa. The MIC50 against levofloxacin was ≥16 µg/ml for ACB complex (both groups) and ≥0.5 µg/ml (non-formers) vs. ≥1 µg/ml (formers) for P. aeruginosa. For meropenem, MIC50 was ≥0.5 µg/ml (non-formers) vs. ≥8 µg/ml (formers) in ACB complex and ≥8 µg/ml vs. ≥16 µg/ml in P. aeruginosa. The MIC50 against imipenem for ACB complex was ≥4 µg/ml (non-formers) vs. ≥8 µg/ml (formers). Biofilm non-forming and forming P. aeruginosa exhibited a similar MIC50 value of ≥0.5 µg/ml. Over three-fourths of the NFGNB infections were caused by the ACB complex, with nearly one-fourth involving biofilm-forming strains, necessitating the need for higher MICs of quinolones and carbapenems.