Evaluation of the simultaneous exposure to ibuprofen and ciprofloxacin on some virulence factors of ciprofloxacin resistant Pseudomonas aeruginosa

Background and Aim : Pseudomonas aeruginosa, is considered one of the leading causes of opportunistic and hospital-acquired infections, worldwide. The infections with P. aeruginosa have been linked with difficulties in clinical treatment because of significant resistance of the bacterium to a variety of antibiotics, including ciprofloxacin. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, have displayed antimicrobial activity. Also, in combination with antibiotics, NSAIDs have exhibited significant synergistic antibacterial effects, suggesting that in combination with ciprofloxacin, these drugs could be more efficient for the treatment of drug resistant infections. Thus, in this study, we aimed to evaluate the effect of simultaneous use of ibuprofen and ciprofloxacin on the virulence factors of clinical isolates of P. aeruginosa.Methods : Ciprofloxacin resistant P. aeruginosa strains were isolated from clinical specimens and were identified using biochemical assays. The antibiotic resistance pattern was determined by the disk diffusion method and the Minimum Inhibitory Concentration (MIC) of ibuprofen and ciprofloxacin against P. aeruginosa was determined by broth microdilution assay. The isolated strains were exposed to ibuprofen, ciprofloxacin, and ibuprofen+ciprofloxacin, at sub-MIC concentration. The proteolytic and hemolytic activities were determined using skim milk agar and blood agar assays, respectively. Bacterial swarming, twitching and growth curve were also studied.Results : The isolates were Gram negative rods and, catalase and oxidase positive which grew in cetrimide agar and EMB agar. The MIC of ibuprofen and ciprofloxacin were determined ۲۰۴۸ and ۳۲ µg/mL. Ibuprofen and ciprofloxacin in combination were able to significantly reduce bacterial hemolysis and proteolysis. Also, bacterial swarming and twitching motility was decreased in the presence of both drugs, compared with either agent alone. In addition, the growth curve analysis showed that bacterial growth was reduced by ۴۷.۴ % among the bacteria treated with ciprofloxacin and ibuprofen compared with control.Conclusion : According to the study, ibuprofen and ciprofloxacin have a promising synergic activity against P. aeruginosa which could be used for therapeutic approaches. However, further characterization must be performed in this issue.

کلیدواژه ها:

Ciprofloxacin ، Ibuprofen ، Pseudomonas aeruginosa ، virulence factors