In-vitro effect of carbapenem in combination to otherantibiotics against Carbapenem-resistant Klebsiella pneumoniae

Background and Aim : The aim of the current study was to investigate in-vitro antibacterial effectof meropenem, amikacin and colistin alone and the various combinations against carbapenemresistantKlebsiella pneumoniaeMethods : Twenty Klebsiella pneumoniae isolates were collected from clinical specimens. Theresistance to meropenem were detected by the disk diffusion and determination of minimuminhibitory concentration (MIC) of meropenem by the broth micro. Inhibitory effect ofantimicrobial agents on biofilm, was studied by determining the minimum biofilm inhibitoryconcentration (MBIC). The synergetic effect of the antibiotics combinations was studied using thecheckerboard assay and the fractional inhibitory concentration (FIC)Results : The highest synergic effect between on planktonic form was found inamikacin/meropenem (۱۷ of ۲۰ isolates), and the lowest synergic interaction was observed incolistin/amikacin (۲ of ۲۰ isolates). Colistin/meropenem were shown synergic effect against ۱۱isolates. The highest synergic inhibitory effect against biofilm was detected in meropenem/colistin(۱۴ of ۲۰ isolates) followed by amikacin/meropenem (۶ of ۲۰ isolates) and meropenem/colistin (۲of ۲۰ isolates)Conclusion : The combination of meropenem, amikacin and colistin had indicated the differenteffects on biofilm form and planktonic form of Klebsiella pneumoniae. Thus, a distinct testing ofinhibitory effects of the antimicrobial drugs in the combination is essential for biofilm forms.Amikacin/meropenem and was more effective against planktonic and meropenem/colistin againstbiofilm forms of Klebsiella pneumoniae

کلیدواژه ها:

Meropenem resistance ، Biofilm ، Klebsiella pneumoniae ، combination therapy