Adaleti, Riza and Nakipoglu, Yasar and Calik, Seyma and Arici, Neslihan and Kansak, Nilgun and Senbayrak, Seniha and Aksaray, Sebahat (2023) Investigation of in vitro efficacy of meropenem/ polymyxin B and meropenem/fosfomycin combinations against carbapenem resistant Klebsiella pneumoniae strains. ACTA MICROBIOLOGICA ET IMMUNOLOGICA HUNGARICA, 70 (2). pp. 155-160. ISSN 1217-8950
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Abstract
The incidence of infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) is increasing worldwide, and very limited number of effective antibiotics are available for therapy. In our study, the in vitro efficacy of meropenem/polymyxin B and meropenem/fosfomycin combinations against CRKP strains was investigated. The efficiency of meropenem/polymyxin B and meropenem/fosfomycin combinations was tested by checkerboard microdilution and checkerboard agar dilution methods, respectively, against 21 CRKP strains containing major carbapenem resistant genes (7 blaKPC, 7 blaOXA-48 gene, and 7 blaOXA-48 thorn blaNDM), and seven additional CRKP strains without carbapenemase genes. Among the 28 CRKP strains, the meropenem/polymyxin B combination was synergistic in ten (35.7%), partially synergistic in 12 (42.8%), and indifferent in six (21.4%) isolates. The meropenem/ fosfomycin combination was found to be synergistic in three isolates (10.7%), partially synergistic in 20 (71.4%), and indifferent in five (17.8%). In 21 strains containing carbapenem resistance genes, meropenem/polymyxin B and meropenem/fosfomycin combinations exhibited synergistic/partial synergistic effects in 15 (71.4%) and 16 (76.2%) strains, respectively, compared to 100% synergistic/partial synergistic efficiency in both combinations in seven strains free of carbapenemase genes. No antagonistic effect was detected in either combination.Regardless of presence or absence of carbapenem resistance genes, meropenem/polymyxin B and meropenem/fosfomycin combinations both demonstrated high synergistic and partial synergistic activity against 78.4% and 82.1% of CRKP strains, respectively. Also, they have no antagonistic effects and can be used successfully to prevent therapeutic failure with monotherapy, according to our in vitro studies.
Item Type: | Article |
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Uncontrolled Keywords: | immunology; Infections; In Vitro; meropenem; klebsiella pneumoniae; fosfomycin; antibiotic combination; |
Subjects: | Q Science / természettudomány > QR Microbiology / mikrobiológia |
SWORD Depositor: | MTMT SWORD |
Depositing User: | MTMT SWORD |
Date Deposited: | 16 Apr 2024 07:17 |
Last Modified: | 30 Jun 2024 23:15 |
URI: | https://real.mtak.hu/id/eprint/192590 |
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