Bicarbonate may alters bacterial susceptibility to antibiotics by targeting Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus

Backgrounds/aims: Acute acidemia is a common clinical condition in critical diseases. Acidemia is associated with poor prognosis in case of persistence. In the case of metabolic acidosis, it is beneficial to increase the pH by administering sodium bicarbonate (NaHCO3) since cell functions are impaired. The aim of this study was to investigate the antibacterial efficacy of NaHCO3 used in metabolic acidosis, especially in critically ill patients in intensive care units, and to reveal its contribution to antimicrobial therapy for possible concomitant sepsis.Method: S.aureus ATCC 29213, P. aeruginosa ATCC 27853 and E. coli ATCC 25922 strains were seeded into liquid Müller Hinton medium (Oxoid, UK) and the in-vitro effect of Group C (Control - 1 mL sterile saline) and Group B (Sodium Bicarbonate - NaHCO3) on these bacteria following 24 hours of incubation at 37 degreesC was investigated. Following the use of Epoch spectrophotometer (BioTek Inst. Inc. Vermont, USA) for the 0. and 24. hours, the growth in wells was analyzed in CFU / mL and log10 CFU/mL by comparison with the standard curve.Results:From the start to the 24. hour, there was a significant decrease in bacterial colony numbers of S.aureus ATCC 29213, P. aeruginosa ATCC 27853 and E. coli ATCC 25922 strains in Group B when compared to the control group (p <0.01). The intra-group antibacterial efficacy comparison revealed a significant decrease in bacterial colony numbers in Group B between 0-24 hours (p<0.01). There was a significant increase in all bacterial colony numbers in the control group (p = 0.04). Conclusion: In our study, NaHCO3 was found to show strong antibacterial efficacy against P. aeruginosa, E. coli and S. aureus. Taking these results into consideration, it should be kept in mind that the use of NaHCO3 in the treatment of severe metabolic acidosis especially seen in septic patients in intensive care units will also contribute to sepsis treatment because of its antibacterial effect potential. We believe that the results of this study, if supported by clinical studies, may contribute to the improvement of treatment efficacy and lower treatment costs in critical patients in the intensive care unit in the case of metabolic acidosis and sepsis.