In Vitro Effects of Vitamin and Mineral Supplements on Antibiotic Resistance Profile of Some ESKAPE Pathogens

Background: Antibiotics once seen as miracle drugs are now becoming inefficient in treating various bacterial diseases. This study aimed to evaluate the effects of vitamin and mineral supplements on the antibiogram profile of some of the multidrug-resistant bacteria, which the Infectious Diseases Society of America (IDSA) has dubbed ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter spp, Pseudomonas aeruginosa, and Enterobacter spp), the predominant cause of hospital-acquired infections (HAIs).

Methodology: The in vitro effects were evaluated using the disc diffusion (Kirby-Bauer) technique. All test bacteria were inoculated onto Mueller-Hinton agar (MHA), supplemented with varying concentrations (2.5, 5, 10, 20, and 25 mg/ml) of vitamin (A, C, or E) and mineral (calcium or iron). Agar without supplements served as the control. The effects of vitamin and mineral supplements were determined by measuring the zones of inhibition to the nearest millimeter as compared to the control.

Result: Zones of inhibition for nalidixic acid and ampicillin on P. aeruginosa significantly increased from 5mm to 32mm and 0mm to 18mm respectively, with increasing concentration of vitamin C. Similarly, nalidixic acid and ampicillin zones of inhibition on P. aeruginosa increased from 5mm to 12mm and 0mm to 18mm respectively, with increasing concentration of vitamin A. Vitamin C resulted in significant decreases in all of the zones of inhibition for all antibiotics against E. coli, except reflacine and ciproflox. Varying concentrations of iron led to a sharp decrease in the zones of inhibition for all antibiotics against S. aureus and K. pneumonia. Significant changes were also observed in all zones of inhibitions for all antibiotics studied under varying concentrations of calcium.

Conclusion: The effects of vitamin and mineral supplements appear to be important but concentration-dependent. However, there is a need to evaluate the in vivo effects of these vitamin and mineral supplements.