Evaluation of Cefixime-Clavulanate Combination by Comparative Disk Diffusion Method in Klebsiella pneumoniae Clinical Isolates-An In-Vitro Study
Journal Title: Journal of Krishna Institute of Medical Sciences University - Year 2015, Vol 4, Issue 2
Abstract
Background: Resistance to cephalosporins due to β-lactamases is a major concern worldwide. However recent trend is to use β-lactamase inhibitor combinations. Potential combination is cefiximeclavulanate. Objective: Present study aims at the comparative evaluation of Fixed-Dose Combination (FDC) of cefixime‑clavulanate and cefixime-alone in Klebsiella pneumoniae clinical isolates. Material and Methods: Study included 200 clinical isolates of K. pneumoniae. The Comparative Antimicrobial Susceptibility Test (AST) of cefixime‑clavulanate (5µg/10µg) combination and cefixime-alone(5µg) was done by measurement and comparison of zone of lysis produced by both. All values were expressed in mean ± SD. Paired‘t’ test was used to determine statistical difference between different groups under study. P values < 0.05 were considered statistically significant. Isolates were tested for ExtendedSpectrum β-lactamase (ESBL), AmpC β-lactamase (AmpC) and metallo β-lactamase (MBL) production by Clinical Laboratory Standards Institute - Phenotypic Disk Confirmatory Test (CLSI-PDCT), AmpC β-lactamase sterile disk test and Imipenem-Ethylene Di-amine Tetracetic Acid – Double disk synergy test (Imipenem-EDTA DDST) respectively. Results: Comparative AST resulted in statistically significant (P < 0.001) increased zones in cefixime‑clavulanate combination than cefixime-alone in all isolates studied. When zones were evaluated separately only in three β-lactamase producing isolates; cefiximeclavulanate combination showed much higher zones in ESBL-producers (n=30) (P < 0.001), but not in AmpC-producers (n=32) (P = 0.5559) and MBLproducers (n=06) (P = 0.7815). Conclusion: Present study demonstrates the best bactericidal killing effect of cefixime-clavulanate compared to cefixime-alone. It is also of therapeutic significance in the treatment of infections caused by K. pneumoniae producing ESBLs. We recommend comparative AST method when commercially available newer β-lactamase inhibitor combination, for which no CLSI interpretive guidelines are available; to be studied systematically, before implementing it in treatment regimen.
Authors and Affiliations
Gajul S. V , Mohite S. T , Kakade S. V , Mangalagi S. S , Wavare S. M
Keywords
Related Articles
- EP ID EP105782
- DOI -
- Views 87
- Downloads 0
Study of Physical Growth Standards of Adolescents in the Age Group of 10 to 15 Years from Satara District of Maharashtra,India
Background: Adolescence is a significant period of human growth and maturation. The reference values are central to the growth monitoring. Aims and Objectives: This study was carried out to develop the mean, standard...
Primary Hydatid Cyst of Thigh: A Case Report in Child
Hydatid cysts grow commonly in liver and lungs, but irregularly they are established in other sites. Occasionally few embryos run away the capillary filtrating systems of the liver and pulmonary and lead to hydatidosis o...
Brain Abscess Caused by Cladophialophora Species
We report a case of 55-year-old male who presented with history of double vision on left side, slurred speech and loss of memory since a week. Computerized tomography scan was done which showed space occupying lesion in...
Adolescent PCO – The Modern Approach
Acute Disseminated Encephalomyelitis in a case of Hyper IgM Syndrome
Hyper IgM syndrome is a rare genetically heterogenoussyndrome and is characterized by an elevated or normalserum IgM and decreased IgG, IgA and IgE, indicatinga defect in the class – switch recombination(CSR) process. Pa...