The Effects of Antidepressants Fluoxetine, Sertraline, and Amitriptyline on the Development of Antibiotic Resistance in Acinetobacter Baumannii
Abstract In this study, we investigated the effects of antidepressants fluoxetine, sertraline, and amitriptyline on the development of antibiotic resistance in Acinetobacter baumannii. Susceptible clinical A. baumannii isolates were exposed to fluoxetine, sertraline, amitriptyline for 30 days, respectively. After exposure, the bacteria that developed resistance to gentamicin, imipenem, colistin, and ciprofloxacin were isolated and expression levels of some antibiotic resistance genes were compared with test bacteria in initial cultures using the quantitative Reverse-Transcriptase PCR method. The data obtained were analyzed using Student's t-test method. Increases in the MIC values of test bacteria were also determined after the exposure. The number of test bacteria that developed resistance and the MIC values of some bacteria were increased with the extension of exposure time. After exposure to fluoxetine and sertraline, decreases were observed for efflux and outer membrane porin genes in isolates that developed colistin resistance, and increases were observed in isolates that developed ciprofloxacin resistance. These observations suggest that these antidepressants have similar effects on the development of resistance. While the exposure to fluoxetine didn’t result in the development of resistance to imipenem, it was observed after exposure to sertraline and amitriptyline, and a common decrease in ompA gene expression was determined in these isolates. This study is one of the preliminary investigations that demonstrates the role of non-antibiotic drugs on the development of antibiotic resistance. To the best of our knowledge, our findings report the comparative effects of selected antidepressants on the development of antibiotic resistance in A. baumanni for the first time in the literature.