Synergistic Effect between Zingiber Officinale Volatile Oil and Meropenem against Acinetobacter Baumannii Producing-Carbapenemase Isolated from Neurosurgery in Iraq

Abstract

Safaa A.L. Al Meani, Mohammed M. Ahmed, Ali H. Abdulkareem.

The existence of bacterial pathogens that are carbapenem-resistant is a big and growing health problem around the world. Carbapenem resistance (CR) is generally considered to be one of the most important resistance mechanisms and is found predominantly in gram-negative bacteria. blaOXA-48 and blaVIM were documented for the first time in this study among Acinetobacter baumannii in hospitalized neurosurgery patients in Anbar, Iraq. The VITEK-2 system tested the susceptibility to various antibiotics, given to notice that from 22 clinical isolates of A. baumannii, 60 % and 55 % were resistant to both meropenem and imipinem, respectively. Phenotypic carbapenemase identification by Blue-carba test, and mCIM that all isolates produced carbapenemases, while (40%) gave a positive result with modified Hodg test. Both of blaOXA and blaVIM genes were detected by multiplex PCR, our results showed 4/7 (57.14%) strains positive for bla OXA gene and 3/7 (42.85%) strains harbored bla VIM. Our results revealed the coexistence of the genes VIM and OXA-48 in three isolates (42.85%) of A. baumannii. The results have shown that there are wide variations in bacterial virulence factors productivity among all A. baummanii isolates such as biofilm and protease activity. All of isolates 10/10(100%) exhibited a biofilm-positive phenotype after 24 h of incubation. In the present study, the percentage of biofilm was 70%(strong), 20%(Intermediate), and 10% (weak). MIC of Ginger, meropenem, and cefepem were 50, 250, and 500 mg/ml, respectively. 10 isolates of Acinetobacter baumannii were investigated on their ability to produce � carbapenmase by using iodometry assay. Ginger volatile oil effects on carbapenemase production and ginger gave a positive result against carbapenmase activity. Ginger volatile oil exhibited synergistic effect when combined with the checkerboard technique with meropenem against A. baumannii, while ganoderma had no effect. Furthermore, appropriate infection prevention procedures must be practiced, and doctors should be mindful of patients with certain risk factors.