Isolation and Identification of Klebsiella Accompanying Accident Wounds and Treatment with Probiotics

A total of (100) samples were collected from patients (referred to three hospitals in Baghdad) suffering of accident wounds included traumatic wounds, foot ulcer and burns. The samples were collected from both sexes during the period 10/12/2009 – 14/3/2010. A total of 22 isolates of Klebsiella were identified depending on cultural, microscopic and biochemical characterizations. Other bacteria obtained were identified as Escherichia coli, Pseudomonas spp., Enterobacter, Proteus and Citrobacter in numbers 25, 23, 6, 5 and 2, respectively. Biochemical and Api-20E system identification revealed that all Klebsiella isolates were belonged to the species K. pneumoniae. Antibiotic susceptibility of K. pneumoniae isolates against (15) of all commonly used antibiotic was determined through disc-diffusion method. After that, well-diffusion method was used to investigate the resistance of K. pneumoniae isolates toward six selected antibiotic solutions. Results declared that, generally, the isolates were resistant to the antibiotics used except their sensitivity to imipenem (in the discdiffusion method) and meronem (in the well-diffusion method). Depending on the antibiotic susceptibility findings, only two isolates were selected; one from traumatic wounds and the other from burns, to study the inhibitory effect of probiotics and using combinations of probiotics- antibiotics in different ratios. For this purpose, the inhibitory effect of three filtrates of Lactobacillus isolates (L.
acidophilus, L. plantarutm and L. gasseri) and a yeast isolate (Saccharomyces boulardii) were determined against the two K pneumoniae isolates. Results showed that Lactobacillus filtrates were more effective in the inhibitory effect on K. pneumoniae isolates than the yeast isolate did. Regarding results of inhibitory effect of probiotics-antibiotics combination, it was found that a ratio of 5:5 each of combinations L.acidophilus: amoxicillin, L. plantarum : amoxicillin and S. boulardii : amoxicillin was the most effective on traumatic wound isolate. Moreover, L. acidophilus : amoxicillin in the same ratio gave effective result on the burn isolate. Concerning combination with ceftriaxone, ratios of 9:1 and 1:9 (S. boulardii: ceftriaxone) and ratios 8:2 and 2:8 (L. gasseri: ceftriaxone) were the most effective treatments against isolate of traumatic wound. All probiotic filtrates when combined with ceftriaxone in a ratio 1:9 exhibited serous affect against burn isolate. Almost similar effect was given by the combination of the filtrates and ceftriaxone in ratios of 8:2 L. acidophilus : ceftriaxone and 2:8 of each of L. plantarum : ceftriaxone, L. gasseri : ceftriaxone. Effect of ofloxacin on the burn isolate was increased when mixing with all probiotic filtrates in ratios of 1:9 and 2:8 probiotic : antibiotic. On traumatic wound, results revealed that the combination of probiotic and ofloxacin gave same (or slightly less) inhibitory effect of ofloxacin (alone). Moreover, mixing meronem with probiotic filtrates had no (or negative) effect in all ratios used against both K. pneumonia isolates.