Investigation of in vitro efficacy of quercetin-meropenem combination in carbapenemase-producing Klebsiella pneumoniae isolates

Introduction: In recent years, the rapid spread of carbapenem-resistant K. pneumoniae, their higher mortality rates, and limited treatment alternatives cause difficulties in the treatment of these infections. New treatment alternatives are needed to cope with resistant strains. In recent years, nat...

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Main Authors: Özlem Aydemir, Gökçen Ormanoğlu, Tuğba Ayhancı, Mustafa Zengin, Mehmet Köroğlu
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2023-09-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/17635
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author Özlem Aydemir
Gökçen Ormanoğlu
Tuğba Ayhancı
Mustafa Zengin
Mehmet Köroğlu
author_facet Özlem Aydemir
Gökçen Ormanoğlu
Tuğba Ayhancı
Mustafa Zengin
Mehmet Köroğlu
author_sort Özlem Aydemir
collection DOAJ
description Introduction: In recent years, the rapid spread of carbapenem-resistant K. pneumoniae, their higher mortality rates, and limited treatment alternatives cause difficulties in the treatment of these infections. New treatment alternatives are needed to cope with resistant strains. In recent years, natural products such as Quercetin have started to be preferred in combination studies due to their antimicrobial effects and low side-effect profiles. The aim of this study was to investigate the in vitro efficacy of the combination of Quercetin and Meropenem on carbapenemase-producing (blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP), carbapenem-resistant K.pneumoniae isolates using the checkerboard method. Methodology: Thirty Carbapenem-resistant K.pneumoniae strains in the culture collection of our laboratory were included in our study. Carbapenemase genes were determined using the Xpert® Carba-R (Cepheid, USA). Synergism with meropenem was assessed by checkerboard analysis, followed by FIC index, and combination index calculation. Results: Twenty (66.6%) strains had OXA-48, 6 (20%) NDM, 1 (3.3%) KPC, 1 (3.3%) OXA-48+NDM genes, and 2 strains (6.6%) gene could not be detected. In the Quercetin and Meropenem combination study, synergy was found in 24 (80%) of the strains; an additive effect was found in 5 (16.6%) and an antagonist effect in 1 (3.3%). In 19 (63.3%) of the strains, meropenem MIC values were below the sensitive limit (MIC ≤ 2 μg/mL). Conclusions: Although the combination of quercetin and meropenem has a high synergistic effect in carbapenem-resistant K. pneumoniae isolates, it seems that the carbapenemase species affects this situation. however, more work is needed on this subject.
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publisher The Journal of Infection in Developing Countries
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spelling doaj-art-2908aba7d84f4a0a96fce4e73d5fde9d2025-08-20T02:57:21ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802023-09-01170910.3855/jidc.17635Investigation of in vitro efficacy of quercetin-meropenem combination in carbapenemase-producing Klebsiella pneumoniae isolatesÖzlem Aydemir0Gökçen Ormanoğlu1Tuğba Ayhancı2Mustafa Zengin3Mehmet Köroğlu4Sakarya University, Faculty of Medicine, Department of Medical Biology, Sakarya, TurkeySakarya University, Faculty of Medicine, Department of Medical Biology, Sakarya, TurkeySakarya University, Faculty of Medicine, Department of Medical Biology, Sakarya, TurkeySakarya University, Faculty of Science and Art, Department of Chemistry, Sakarya, TurkeySakarya University, Faculty of Medicine, Department of Medical Biology, Sakarya, Turkey Introduction: In recent years, the rapid spread of carbapenem-resistant K. pneumoniae, their higher mortality rates, and limited treatment alternatives cause difficulties in the treatment of these infections. New treatment alternatives are needed to cope with resistant strains. In recent years, natural products such as Quercetin have started to be preferred in combination studies due to their antimicrobial effects and low side-effect profiles. The aim of this study was to investigate the in vitro efficacy of the combination of Quercetin and Meropenem on carbapenemase-producing (blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP), carbapenem-resistant K.pneumoniae isolates using the checkerboard method. Methodology: Thirty Carbapenem-resistant K.pneumoniae strains in the culture collection of our laboratory were included in our study. Carbapenemase genes were determined using the Xpert® Carba-R (Cepheid, USA). Synergism with meropenem was assessed by checkerboard analysis, followed by FIC index, and combination index calculation. Results: Twenty (66.6%) strains had OXA-48, 6 (20%) NDM, 1 (3.3%) KPC, 1 (3.3%) OXA-48+NDM genes, and 2 strains (6.6%) gene could not be detected. In the Quercetin and Meropenem combination study, synergy was found in 24 (80%) of the strains; an additive effect was found in 5 (16.6%) and an antagonist effect in 1 (3.3%). In 19 (63.3%) of the strains, meropenem MIC values were below the sensitive limit (MIC ≤ 2 μg/mL). Conclusions: Although the combination of quercetin and meropenem has a high synergistic effect in carbapenem-resistant K. pneumoniae isolates, it seems that the carbapenemase species affects this situation. however, more work is needed on this subject. https://jidc.org/index.php/journal/article/view/17635Quercetincarbapenem-resistant Klebsiella pneumoniaecheckerboard methodmeropenem
spellingShingle Özlem Aydemir
Gökçen Ormanoğlu
Tuğba Ayhancı
Mustafa Zengin
Mehmet Köroğlu
Investigation of in vitro efficacy of quercetin-meropenem combination in carbapenemase-producing Klebsiella pneumoniae isolates
Journal of Infection in Developing Countries
Quercetin
carbapenem-resistant Klebsiella pneumoniae
checkerboard method
meropenem
title Investigation of in vitro efficacy of quercetin-meropenem combination in carbapenemase-producing Klebsiella pneumoniae isolates
title_full Investigation of in vitro efficacy of quercetin-meropenem combination in carbapenemase-producing Klebsiella pneumoniae isolates
title_fullStr Investigation of in vitro efficacy of quercetin-meropenem combination in carbapenemase-producing Klebsiella pneumoniae isolates
title_full_unstemmed Investigation of in vitro efficacy of quercetin-meropenem combination in carbapenemase-producing Klebsiella pneumoniae isolates
title_short Investigation of in vitro efficacy of quercetin-meropenem combination in carbapenemase-producing Klebsiella pneumoniae isolates
title_sort investigation of in vitro efficacy of quercetin meropenem combination in carbapenemase producing klebsiella pneumoniae isolates
topic Quercetin
carbapenem-resistant Klebsiella pneumoniae
checkerboard method
meropenem
url https://jidc.org/index.php/journal/article/view/17635
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