Experimental of combination of two carbapenem on carbapenemase-producing klebsiella pneumoniae using checkerboard method

https://doi.org/10.52322/jocmbmh.120.04

Abstract

Objectives: The aim of this study was to evaluate the synergy activity in vitro of double carbapenem combinations against carbapenemase producing Klebsiella pneumoniae clinical isolates.

Material and Methods: We evaluated the synergy activity in vitro of double-carbapenem  combinations (ertapenem+meropenem và ertapenem+imipenem) against 50 carbapenem-producing Klebsiella pneumoniae strains using checkerboard.

Results: Combination of ertapenem+meropenem and ertapenem+imipenem were synergic in 0/50 and 8/50 of the strains, respectively. At MIC of imipenem being 1,2,4,8,16,32,64,128; the synergy activities were observed in 0/1, 1/1, 3/12, 2/22, 2/9, 0/1, 0/3, 0/1, respectively. At MIC of ertapenem being 2,4,8,16,32,64,128; the synergy activities were observed 0/1, 2/2, 1/1, 1/3, 0/4, 2/15, 2/24, respectively. Synergy were observed in 2/14, 1/9, 5/25, 0/2 of strains producing KPC, NDM, OXA-48, NDM+OXA-48 combination, respectively.

Conclusions: Ertapenem+imipenem combination was more synergic than ertapenem+meropenem. Synergy tended to be in strains with low MIC of carbapenem. Synergy was observed at all three types of carbapenemase KPC, NDM, OXA-48.