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. 2024 Oct 26;24(1):1208.
doi: 10.1186/s12879-024-10081-0.

Synergistic effects of bacteriophage cocktail and antibiotics combinations against extensively drug-resistant Acinetobacter baumannii

Sanaz Rastegar  1   2 , Mikael Skurnik  3 , Omid Tadjrobehkar  2   4 , Ali Samareh  5 , Mohammad Samare-Najaf  6 , Zahra Lotfian  2 , Maryam Khajedadian  2 , Hossein Hosseini-Nave  7   8   9 , Salehe Sabouri  10   11
Affiliations

Synergistic effects of bacteriophage cocktail and antibiotics combinations against extensively drug-resistant Acinetobacter baumannii

Sanaz Rastegar et al. BMC Infect Dis. .

Abstract

Background: The extensively drug-resistant (XDR) strains of Acinetobacter baumannii have become a major cause of nosocomial infections, increasing morbidity and mortality worldwide. Many different treatments, including phage therapy, are attractive ways to overcome the challenges of antibiotic resistance.

Methods: This study investigates the biofilm formation ability of 30 XDR A. baumannii isolates and the efficacy of a cocktail of four tempetate bacteriophages (SA1, Eve, Ftm, and Gln) and different antibiotics (ampicillin/sulbactam, meropenem, and colistin) in inhibiting and degrading the biofilms of these strains.

Results: The majority (83.3%) of the strains exhibited strong biofilm formation. The bacteriophage cocktail showed varying degrees of effectiveness against A. baumannii biofilms, with higher concentrations generally leading to more significant inhibition and degradation rates. The antibiotics-bacteriophage cocktail combinations also enhanced the inhibition and degradation of biofilms.

Conclusion: The findings suggested that the bacteriophage cocktail is an effective tool in combating A. baumannii biofilms, with its efficacy depending on the concentration. Combining antibiotics with the bacteriophage cocktail improved the inhibition and removal of biofilms, indicating a promising strategy for managing A. baumannii infections. These results contribute to our understanding of biofilm dynamics and the potential of bacteriophage cocktails as a novel therapeutic approach to combat antibiotic-resistant bacteria.

Keywords: Acinetobacter baumannii; Bacteriophage; Extensively drug-resistant; Siphovirus; Synergistic effect.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Biofilms formed by XDR A. baumannii clinical isolates cultured for 24 h, as analyzed by safranin staining procedure and shown as OD values measured at a wavelength of 490 nm. All assays were performed in triplicates. The values presented are mean ± SD from two readings of triplicate experiments (n = 10)
Fig. 2
Fig. 2
Effect of the phage cocktail at different MOIs on the degradation of A. baumannii biofilm; A-J: A. baumannii isolates; ns: P > 0.05; *: P ≤ 0.05; **: P ≤ 0.01; ***: P ≤ 0.001; ****: P ≤ 0.0001; Positive control: biofilm formed by bacterial isolates without treatment
Fig. 3
Fig. 3
Effect of bacteriophage cocktail at different MOIs on inhibition of A. baumannii biofilm formation; A-J: The A. baumannii isolates; MOI: multiplicity of infection; ns: P > 0.05; *: P ≤ 0.05; **: P ≤ 0.01; ***: P ≤ 0.001; ****: P ≤ 0.0001; Positive control: biofilm formed by bacterial without isolates treatment
Fig. 4
Fig. 4
Effect of bacteriophage cocktail (PhC), ampicillin-sulbactam (A.S), and their combinations on the degradation of biofilm. A-J: A. baumannii isolates; MIC: Minimum inhibitory concentration; MOI: multiplicity of infection. ns: P > 0.05; *: P ≤ 0.05; **: P ≤ 0.01; ***: P ≤ 0.001; ****: P ≤ 0.0001; Positive control: biofilm formed by bacterial isolates without treatment
Fig. 5
Fig. 5
Effect of bacteriophage cocktail (PhC), ampicillin/sulbactam (A.S) and their combinations on inhibition of biofilm formation; A-J: A. baumannii isolates; MIC: Minimum inhibitory concentration; MOI: multiplicity of infection; A.S: ampicillin/sulbactam; ns: P > 0.05; *: P ≤ 0.05; **: P ≤ 0.01; ***: P ≤ 0.001; ****: P ≤ 0.0001; Positive control: biofilm formed by bacterial isolates without treatment
Fig. 6
Fig. 6
Effect of bacteriophage cocktail (PhC), meropenem (Mer), and their combinations on biofilm degradation. A-J: A. baumannii isolates. MIC: Minimum inhibitory concentration. MOI: multiplicity of infection. ns: P > 0.05; *: P ≤ 0.05; **: P ≤ 0.01; ***: P ≤ 0.001; ****: P ≤ 0.0001; Positive control: biofilm formed by bacterial isolates without treatment
Fig. 7
Fig. 7
Effect of bacteriophage cocktail (PhC), meropenem (Mer), and their combinations on inhibition of biofilm formation. A-J: A. baumannii isolates. MIC: Minimum inhibitory concentration. MOI: multiplicity of infection. ns: P > 0.05; *: P ≤ 0.05; **: P ≤ 0.01; ***: P ≤ 0.001; ****: P ≤ 0.0001; Positive control: biofilm formed by bacterial isolates without treatment
Fig. 8
Fig. 8
Effect of bacteriophage cocktail (PhC) and colistin (Col) on biofilm degradation. A-J: A. baumannii isolates. MIC: Minimum inhibitory concentration. MOI: multiplicity of infection. ns: P > 0.05; *: P ≤ 0.05; **: P ≤ 0.01; ***: P ≤ 0.001; ****: P ≤ 0.0001; Positive control: biofilm formed by bacterial isolates without treatment
Fig. 9
Fig. 9
Effect of bacteriophage cocktail (PhC) and colistin (Col) on inhibition of biofilm formation. A-J: A. baumannii isolates; MIC: Minimum inhibitory concentration. MOI: multiplicity of infection. P > 0.05; *: P ≤ 0.05; **: P ≤ 0.01; ***: P ≤ 0.001; ****: P ≤ 0.0001; Positive control: biofilm formed by bacterial isolates without treatment
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