Fig. 4

Relative expression level of efflux pump genes with combination treatment of imipenem with cinnamon oil, trimethoprim and CCCP against two clinical CRAB strains (ACN15, and ACN99). RT-qPCR test was done to assess the effect of the treatments on AdeABC and AdeJIK in A. baumannii strains. Relative mRNA levels of target efflux pumps genes; a. adeJ, b. adeK, c. adeB, and d. adeC were normalized to the geometric mean of reference genes (rpoB). The vertical bars represent mean ± S.D of triplicate independent experiments (n = 3). Data were analyzed using t-student test (****p <0.0001). A. baumannii CRAB ACN15, and ACN99 strains, and A. baumannii strain (ACN 15, control strain) were grown at a sub-inhibitory concentration of IMP (8 and 128 μg/mL) for control strain and EPI (cinnamon oil, Trimethoprim, and CCCP) combined with IMP overnight at 37^°C on CA- MHA plates, e. Heatmap graph represents fold change in relative gene expression of adeJ, adeB, adeC and adeK genes of CRAB strains (ACN15, and ACN99) after combination treatments comparing with A. baumannii strain (ACN15, control strain), f. Bimodal figure for to dissemination of amplified efflux pump genes associated with the AdeABC and AdeIJK system in two selected isolates after treatment with EPI, and g. Bimodal figure for distribution of imipenem MICs in 37 clinical CRAb strains classified according to dissemination of amplified efflux pump genes associated with the AdeABC and AdeIJK system