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Investigation of double-carbapenem efficiency in experimental sepsis of colistin-resistant Klebsiella pneumoniae

OBJECTIVE: Klebsiella pneumoniae, a Gram-negative pathogen, especially which produces carbapenemase, is seen as a major threat to public health due to rapid plasmid-mediated spread of resistance and limited therapeutic options available for treatment. Although colistin has been recognized as a “last...

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Autores principales: Kosar, Imran, Dinc, Gokcen, Eren, Esma, Aykemat, Yusuf, Kilic, Mesut, Kilic, Huseyin, Doganay, Mehmet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8039106/
https://www.ncbi.nlm.nih.gov/pubmed/33851073
http://dx.doi.org/10.14744/nci.2020.14238
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author Kosar, Imran
Dinc, Gokcen
Eren, Esma
Aykemat, Yusuf
Kilic, Mesut
Kilic, Huseyin
Doganay, Mehmet
author_facet Kosar, Imran
Dinc, Gokcen
Eren, Esma
Aykemat, Yusuf
Kilic, Mesut
Kilic, Huseyin
Doganay, Mehmet
author_sort Kosar, Imran
collection PubMed
description OBJECTIVE: Klebsiella pneumoniae, a Gram-negative pathogen, especially which produces carbapenemase, is seen as a major threat to public health due to rapid plasmid-mediated spread of resistance and limited therapeutic options available for treatment. Although colistin has been recognized as a “last resort” antimicrobial for multidrug-resistant K. pneumoniae infections, these isolates have developed resistance to colistin as a result of its intensive use. The aim of this study was to evaluate the efficacy of double-carbapenem treatment of colistin-resistant K. pneumoniae experimental sepsis in mice. METHODS: In the study, 8–10-week-old Balb-c mice were divided as control groups (positive and negative) and treatment groups (colistin, ertapenem+meropenem, and ertapenem+meropenem+colistin). Sepsis was developed in mice by an intraperitoneal injection of colistin resistant K. pneumoniae. Antibiotics were given intraperitoneally 3 h after bacterial inoculation. Mice in each subgroup were sacrificed with overdose anesthetic at the end of 24–48 h and cultures were made from the heart, lung, liver, and spleen. Furthermore, homogenates of lung and liver were used to detect the number of colony-forming units per gram. Bacterial clearance was evaluated in lung and liver at different time points. RESULTS: When the quantitative bacterial loads in the lung and liver tissues are evaluated, no statistically significant difference was observed between different antibiotic treatments (p>0.05). All three treatment options were not effective, especially in 24 h. Only the decrease in bacterial load at the 48(th) h of the group treated with ertapenem + meropenem + colistin was found significant (p<0.05) compared to the 24 h. CONCLUSION: In the light of these data, it was understood that double-carbapenem application was not sufficient in the treatment of experimental sepsis in mice with colistin-resistant K. pneumoniae. Furthermore, ertapenem + meropenem + colistin combined therapy was not found to be superior to colistin monotherapy or double-carbapenem therapy.
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spelling pubmed-80391062021-04-12 Investigation of double-carbapenem efficiency in experimental sepsis of colistin-resistant Klebsiella pneumoniae Kosar, Imran Dinc, Gokcen Eren, Esma Aykemat, Yusuf Kilic, Mesut Kilic, Huseyin Doganay, Mehmet North Clin Istanb Original Article OBJECTIVE: Klebsiella pneumoniae, a Gram-negative pathogen, especially which produces carbapenemase, is seen as a major threat to public health due to rapid plasmid-mediated spread of resistance and limited therapeutic options available for treatment. Although colistin has been recognized as a “last resort” antimicrobial for multidrug-resistant K. pneumoniae infections, these isolates have developed resistance to colistin as a result of its intensive use. The aim of this study was to evaluate the efficacy of double-carbapenem treatment of colistin-resistant K. pneumoniae experimental sepsis in mice. METHODS: In the study, 8–10-week-old Balb-c mice were divided as control groups (positive and negative) and treatment groups (colistin, ertapenem+meropenem, and ertapenem+meropenem+colistin). Sepsis was developed in mice by an intraperitoneal injection of colistin resistant K. pneumoniae. Antibiotics were given intraperitoneally 3 h after bacterial inoculation. Mice in each subgroup were sacrificed with overdose anesthetic at the end of 24–48 h and cultures were made from the heart, lung, liver, and spleen. Furthermore, homogenates of lung and liver were used to detect the number of colony-forming units per gram. Bacterial clearance was evaluated in lung and liver at different time points. RESULTS: When the quantitative bacterial loads in the lung and liver tissues are evaluated, no statistically significant difference was observed between different antibiotic treatments (p>0.05). All three treatment options were not effective, especially in 24 h. Only the decrease in bacterial load at the 48(th) h of the group treated with ertapenem + meropenem + colistin was found significant (p<0.05) compared to the 24 h. CONCLUSION: In the light of these data, it was understood that double-carbapenem application was not sufficient in the treatment of experimental sepsis in mice with colistin-resistant K. pneumoniae. Furthermore, ertapenem + meropenem + colistin combined therapy was not found to be superior to colistin monotherapy or double-carbapenem therapy. Kare Publishing 2021-03-10 /pmc/articles/PMC8039106/ /pubmed/33851073 http://dx.doi.org/10.14744/nci.2020.14238 Text en Copyright: © 2021 by Istanbul Northern Anatolian Association of Public Hospitals https://creativecommons.org/licenses/by-nc-sa/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
spellingShingle Original Article
Kosar, Imran
Dinc, Gokcen
Eren, Esma
Aykemat, Yusuf
Kilic, Mesut
Kilic, Huseyin
Doganay, Mehmet
Investigation of double-carbapenem efficiency in experimental sepsis of colistin-resistant Klebsiella pneumoniae
title Investigation of double-carbapenem efficiency in experimental sepsis of colistin-resistant Klebsiella pneumoniae
title_full Investigation of double-carbapenem efficiency in experimental sepsis of colistin-resistant Klebsiella pneumoniae
title_fullStr Investigation of double-carbapenem efficiency in experimental sepsis of colistin-resistant Klebsiella pneumoniae
title_full_unstemmed Investigation of double-carbapenem efficiency in experimental sepsis of colistin-resistant Klebsiella pneumoniae
title_short Investigation of double-carbapenem efficiency in experimental sepsis of colistin-resistant Klebsiella pneumoniae
title_sort investigation of double-carbapenem efficiency in experimental sepsis of colistin-resistant klebsiella pneumoniae
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8039106/
https://www.ncbi.nlm.nih.gov/pubmed/33851073
http://dx.doi.org/10.14744/nci.2020.14238
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