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In vitro Effectiveness of Lecithin-Containing Antibiotic Lock Solutions on Klebsiella pneumoniae Biofilms

Yıl 2020, Cilt: 10 Sayı: 1, 94 - 99, 31.01.2020
https://doi.org/10.33631/duzcesbed.600413

Öz

Aim: Klebsiella pneumoniae which is a gram
negative, generally capsulated, non-moving, non-sporing bacteria, nowadays to
be an important cause of community-acquired and nosocomial infection. These
bacteria can cause catheter related infections by forming biofilm on the
surface of catheter. The most effective treatment method of catheter related
infection is to remove infectious catheter and start systemic antibiotic
treatment but this process can't be practiced in all cases due to the patients’
health conditions. Infectious Diseases Society of America and Centers for
Disease Control and Prevention suggest that systemic antibiotic therapy
together with antibiotic lock therapy (ALT), as an adjuvant therapy, for
patients whose infectious catheter can't be removed.

Material and Methods: In our study,
the in vitro efficacy of several antibiotics alone or in combination with
lecithin which is a surface active agent, as a 96 hour lock solution on in
vitro CVC biofilm model against two biofilm-embedded catheter related
bacteremia infection agents Klebsiella
pneumoniae
strains were investigated.

Results: According to our results, ALT solutions containing lecithin+tobramycin
and lecithin+doripenem combinations had an antagonist effect on the
biofilm-embedded strains by increasing at least 2-log10 in both
strains and ALT solutions containing lecithin+colistin, lecithin+tigecycline
and lecithin+ciprofloxacin had less effect than antibiotics alone on the
biofilm-embedded strains.







Conclusion: In our study, we
believe that because lecithin+tobramycin and lecithin+doripenem combinations
showed antagonist activity, the usage of lecithin in daily life as a
nutritional supplement will be a guide for clinicians.

Kaynakça

  • 1. Donlan RM. Biofilms on central venous catheters: is eradication possible? Curr Topics Microbiol Immunol. 2008; 322: 133-61.
  • 2. Lee MY, Ko KS, Song JH. In vitro effectiveness of the antimicrobial lock technique (ALT) for the treatment of catheter-related infections by Pseudomonas aeruginosa and Klebsiella pneumoniae. J Antimicrob Chemother. 2007; 60(4): 782-7. https://doi.org/10.1093/jac/dkm295.
  • 3. Costerton JW, Stewart PS, Greenberg EP. Bacterial biofilms: a common cause of persistent infections. Science. 1999; 284(5418): 1318-22. doi: 10.1126/science.284.5418.1318.
  • 4. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter related infection: 2009 update by the infectious diseases society of America. IDSA Guidelines for intravascular catheter related infection. Clin Infect Dis. 2009; 49(1): 1-45. doi: 10.1086/599376.
  • 5. Raad I, Hanna H, Dvorak T, Chaiban G, Hachem R. Optimal antimicrobial catheter lock solution, using different combinations of minocycline, EDTA, and 25-percent ethanol, rapidly eradicates organisms embedded in biofilm. Antimicrob Agents Chemother. 2007; 51(1): 78-83. doi:10.1128/AAC.00154-06.
  • 6. Epa.gov [Internet]. Washington, DC, USA: US Environmental Protection Agency Office of Pesticide Programs, Office of Pesticide Programs Microbiology Laboratory Environmental Science Center, Ft. Meade, MD [Updated: 2016 Nov 08; Cited: 2019 Apr 5]. Available from: https://www.epa.gov/sites/production/files/2016-08/documents/mb-05-14.pdf.
  • 7. Mataracı Kara E, Özbek Çelik B. Investigation of the effects of various antibiotics against Klebsiella pneumoniae biofilms on in vitro catheter model. Journal of Chemotherapy. 2018; 30(2): 82-8. doi: 10.1080/1120009X.2017.1390633.
  • 8. Raad II, Hanna H, Maki D. Intravascular catheter-related infections: advances in diagnosis, prevention, and management. Lancet Infect Dis. 2007; 7(10): 645-57. https://doi.org/10.1016/S1473-3099(07)70235-9.
  • 9. en-standard.eu [Internet]. Czech Republic: European Standard Store [Updated: 2018 May 15; Cited: 2019 Apr 5]. Available from: https://www.en-standard.eu/18-30373116-dc-bs-en-1276-chemical-disinfectants-and-antiseptics-quantitative-suspension-test-for-the-evaluation-of-bactericidal-activity-of-chemical-disinfectants-and-antiseptics-used-in-food-industrial-domestic-and-institutional-areas-test-method-and-re/.
  • 10. Singh VK, Pandey PM, Agarwal T, Kumar D, Banerjee I, Anis A, et al. Development of soy lecithin based novel self-assembled emulsion hydrogels. J Mechanical Behavior of Biomedical Materials. 2016; 55: 250-63. doi: 10.1016/j.jmbbm.2015.10.027.
  • 11. pharmacopeia.cn [Internet]. USA: The United States Pharmacopeia [Updated: 2008 May 15; Cited: 2019 Mar 1]. Available from: http://www.pharmacopeia.cn/v29240/usp29nf24s0_c1227.html.
  • 12. Aumeran C, Thibert E, Chapelle FA, Hennequin C, Lesens O, Traore O. Assessment on experimental bacterial biofilms and clinical practice of the efficacy of sampling solutions for microbiological testing of endoscopes. J Clin Microbiol. 2012; 50(3): 938-42. doi: 10.1128/JCM.06221-11.
  • 13. Kumon H, Hashimoto H, Nishimura M, Monden K, Ono N. Catheter-associated urinary tract infections: impact of catheter materials on their management. Int J Antimicrob Agents. 2001; 17: 311-6. https://doi.org/10.1016/S0924-8579(00)00360-5.
  • 14. eucast.org [Internet]. Basel Switzerland: European Society of Clinical Microbiology and Infectious Diseases [Updated: 2019 Jan 1; Cited: 2019 Apr 1]. Available from: http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_9.0_Breakpoint_Tables.pdf.
  • 15. Stepanovic S, Vukovic D, Dakic I, Savic B, Svabic-Vlahovic M. A modified microtiter-plate test for quantification of staphylococcal biofilm formation. J Microbiol Methods. 2000; 40(2): 175-9. https://doi.org/10.1016/S0167-7012(00)00122-6.
  • 16. clsi.org [Internet]. Wayne, PA: Clinical and Laboratory Standards Institute [Updated: 1999 Sep 1; Cited: 2019 Mar 1]. Available from: https://clsi.org/standards/products/microbiology/documents/m26/.
  • 17. Justo JA, Bookstaver PB. Antibiotic lock therapy: review of technique and logistical challenges. Infect Drug Resist. 2014; 7: 343-63. doi: 10.2147/IDR.S51388.
  • 18. Özbek Çelik B, Mataraci Kara E. Comparative in vitro efficacies of various antipseudomonal antibiotics based catheter lock solutions on eradication of Pseudomonas aeruginosa biofilms. J Chemother. 2016; 28(1): 20-4. https://doi.org/10.1179/1973947814Y.0000000212.11
  • 19. Tudorache B, Lupulescu R, Dutan I, Sarbulescu A. Assessment of various psychopharmacological combinations in the treatment of presenile and senile primary degenerative dementia. Rom J Neurol Psychiatry. 1990; 28(4): 277-94.
  • 20. Volz HP, Hehnke U, Hauke W. Improvement in quality of life in the elderly. Results of a placebo-controlled study on the efficacy and tolerability of lecithin fluid in patients with impaired cognitive functions. MMW Fortschr Med. 2014; 12-146(Suppl 3-4): 99-106.
  • 21. Weintraub S, Mesulan MM, Auty R, Baratz R, Cholakos BN, Kapust L, et al. Lecithin in the treatment of Alzheimer's disease. Arch Neurol. 1983; 40(8): 527-8.
  • 22. Wu Y, Wang T. Soybean lecithin fractionation and functionality. JAOCS. 2003; 80(4): 319-26.
  • 23. Droste JC, Jeraj HA, MacDonald A, Farrington K. Stability and in vitro efficacy of antibiotic-heparin lock solutions potentially useful for treatment of central venous catheter related sepsis. J Antimicrob Chemother. 2003; 51(4): 849-55. https://doi.org/10.1093/jac/dkg179.
  • 24. Aslam S, Trautner BW, Ramanathan V, Darouiche RO. Combination of tigecycline and N-acetylcysteine reduces biofilm-embedded bacteria on vascular catheters. Antimicrob Agents Chemother. 2007; 51(4): 1556-68. doi: 10.1128/AAC.00893-06.

Lesitin İçeren Antibiyotik Kilit Çözeltilerinin Klebsiella pneumoniae Biyofilmi Üzerine in vitro Etkileri

Yıl 2020, Cilt: 10 Sayı: 1, 94 - 99, 31.01.2020
https://doi.org/10.33631/duzcesbed.600413

Öz



Amaç: Gram negatif,
genellikle kapsüllü, hareketsiz, sporsuz, çomak şeklinde bir bakteri olan Klebsiella pneumoniae günümüzde toplum
ve hastane kökenli enfeksiyonların önemli etkenlerinden biridir. Bu bakteri
kateter yüzeyinde bir mikrobiyal biyofilm oluşturarak kateter ilişkili
enfeksiyonlara neden olabilmektedir. Kateter ilişkili enfeksiyonların
tedavisinde en etkili tedavi yöntemi enfekte kateteri çıkarmak ve sistemik
antibiyotik tedavisine başlamak olsa da bu işlem hastanın sağlık durumu ile
ilgili nedenlerle her zaman yapılamamaktadır. Enfekte kateterin çıkartılamadığı
hastalarda sistemik antimikrobiyal tedavi ile birlikte yardımcı bir tedavi
seçeneği olarak antibiyotik kilit (AK) tedavisi kullanılması Infectious
Diseases Society of America ve Centers for Disease Control and Prevention gibi
sağlık kuruluşları tarafından önerilmektedir.

Gereç ve
Yöntemler:

Çalışmamızda, in vitro yöntemle santral venöz kateter (SVK) modeli
oluşturularak biyofilm oluşturduğu tespit edilen iki SVK ilişkili bakteriyemi
enfeksiyon etkeni Klebsiella pneumoniae
suşuna karşı bir yüzey aktif ajan olan lesitinin tek başına ve çeşitli
antibiyotiklerle kombinasyonlarının 96 saatlik etkisi araştırılmıştır.

Bulgular: Çalışmamızdan
elde ettiğimiz sonuçlara göre, lesitin+tobramisin ve lesitin+doripenem
kombinasyonlarını içeren AK çözeltisinin her iki suş içinde en az 2-log10’luk
bir artış sağlayarak biyofilme gömülmüş suşlar üzerinde antagonist etki
oluşturduğu, lesitin+kolistin, lesitin+tigesiklin ve lesitin+siprofloksasin
içeren AK çözeltilerinin ise her iki suşa ait kateter biyofilm modelinde
antibiyotiklerin tek başına oluşturduğu etkiden daha az etki gösterdiği
saptanmıştır.







Sonuç: Çalışmamızda lesitin+tobramisin
ve lesitin+doripenem kombinasyonlarının antagonist etki göstermesi günlük
hayatta tükettiğimiz pek çok üründe gıda takviyesi olarak bulunan lesitinin
enfeksiyon hastalıklarının tedavisindeki etkilerinin ortaya koyulması açısından
önemli olduğu düşüncesindeyiz.

Kaynakça

  • 1. Donlan RM. Biofilms on central venous catheters: is eradication possible? Curr Topics Microbiol Immunol. 2008; 322: 133-61.
  • 2. Lee MY, Ko KS, Song JH. In vitro effectiveness of the antimicrobial lock technique (ALT) for the treatment of catheter-related infections by Pseudomonas aeruginosa and Klebsiella pneumoniae. J Antimicrob Chemother. 2007; 60(4): 782-7. https://doi.org/10.1093/jac/dkm295.
  • 3. Costerton JW, Stewart PS, Greenberg EP. Bacterial biofilms: a common cause of persistent infections. Science. 1999; 284(5418): 1318-22. doi: 10.1126/science.284.5418.1318.
  • 4. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter related infection: 2009 update by the infectious diseases society of America. IDSA Guidelines for intravascular catheter related infection. Clin Infect Dis. 2009; 49(1): 1-45. doi: 10.1086/599376.
  • 5. Raad I, Hanna H, Dvorak T, Chaiban G, Hachem R. Optimal antimicrobial catheter lock solution, using different combinations of minocycline, EDTA, and 25-percent ethanol, rapidly eradicates organisms embedded in biofilm. Antimicrob Agents Chemother. 2007; 51(1): 78-83. doi:10.1128/AAC.00154-06.
  • 6. Epa.gov [Internet]. Washington, DC, USA: US Environmental Protection Agency Office of Pesticide Programs, Office of Pesticide Programs Microbiology Laboratory Environmental Science Center, Ft. Meade, MD [Updated: 2016 Nov 08; Cited: 2019 Apr 5]. Available from: https://www.epa.gov/sites/production/files/2016-08/documents/mb-05-14.pdf.
  • 7. Mataracı Kara E, Özbek Çelik B. Investigation of the effects of various antibiotics against Klebsiella pneumoniae biofilms on in vitro catheter model. Journal of Chemotherapy. 2018; 30(2): 82-8. doi: 10.1080/1120009X.2017.1390633.
  • 8. Raad II, Hanna H, Maki D. Intravascular catheter-related infections: advances in diagnosis, prevention, and management. Lancet Infect Dis. 2007; 7(10): 645-57. https://doi.org/10.1016/S1473-3099(07)70235-9.
  • 9. en-standard.eu [Internet]. Czech Republic: European Standard Store [Updated: 2018 May 15; Cited: 2019 Apr 5]. Available from: https://www.en-standard.eu/18-30373116-dc-bs-en-1276-chemical-disinfectants-and-antiseptics-quantitative-suspension-test-for-the-evaluation-of-bactericidal-activity-of-chemical-disinfectants-and-antiseptics-used-in-food-industrial-domestic-and-institutional-areas-test-method-and-re/.
  • 10. Singh VK, Pandey PM, Agarwal T, Kumar D, Banerjee I, Anis A, et al. Development of soy lecithin based novel self-assembled emulsion hydrogels. J Mechanical Behavior of Biomedical Materials. 2016; 55: 250-63. doi: 10.1016/j.jmbbm.2015.10.027.
  • 11. pharmacopeia.cn [Internet]. USA: The United States Pharmacopeia [Updated: 2008 May 15; Cited: 2019 Mar 1]. Available from: http://www.pharmacopeia.cn/v29240/usp29nf24s0_c1227.html.
  • 12. Aumeran C, Thibert E, Chapelle FA, Hennequin C, Lesens O, Traore O. Assessment on experimental bacterial biofilms and clinical practice of the efficacy of sampling solutions for microbiological testing of endoscopes. J Clin Microbiol. 2012; 50(3): 938-42. doi: 10.1128/JCM.06221-11.
  • 13. Kumon H, Hashimoto H, Nishimura M, Monden K, Ono N. Catheter-associated urinary tract infections: impact of catheter materials on their management. Int J Antimicrob Agents. 2001; 17: 311-6. https://doi.org/10.1016/S0924-8579(00)00360-5.
  • 14. eucast.org [Internet]. Basel Switzerland: European Society of Clinical Microbiology and Infectious Diseases [Updated: 2019 Jan 1; Cited: 2019 Apr 1]. Available from: http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_9.0_Breakpoint_Tables.pdf.
  • 15. Stepanovic S, Vukovic D, Dakic I, Savic B, Svabic-Vlahovic M. A modified microtiter-plate test for quantification of staphylococcal biofilm formation. J Microbiol Methods. 2000; 40(2): 175-9. https://doi.org/10.1016/S0167-7012(00)00122-6.
  • 16. clsi.org [Internet]. Wayne, PA: Clinical and Laboratory Standards Institute [Updated: 1999 Sep 1; Cited: 2019 Mar 1]. Available from: https://clsi.org/standards/products/microbiology/documents/m26/.
  • 17. Justo JA, Bookstaver PB. Antibiotic lock therapy: review of technique and logistical challenges. Infect Drug Resist. 2014; 7: 343-63. doi: 10.2147/IDR.S51388.
  • 18. Özbek Çelik B, Mataraci Kara E. Comparative in vitro efficacies of various antipseudomonal antibiotics based catheter lock solutions on eradication of Pseudomonas aeruginosa biofilms. J Chemother. 2016; 28(1): 20-4. https://doi.org/10.1179/1973947814Y.0000000212.11
  • 19. Tudorache B, Lupulescu R, Dutan I, Sarbulescu A. Assessment of various psychopharmacological combinations in the treatment of presenile and senile primary degenerative dementia. Rom J Neurol Psychiatry. 1990; 28(4): 277-94.
  • 20. Volz HP, Hehnke U, Hauke W. Improvement in quality of life in the elderly. Results of a placebo-controlled study on the efficacy and tolerability of lecithin fluid in patients with impaired cognitive functions. MMW Fortschr Med. 2014; 12-146(Suppl 3-4): 99-106.
  • 21. Weintraub S, Mesulan MM, Auty R, Baratz R, Cholakos BN, Kapust L, et al. Lecithin in the treatment of Alzheimer's disease. Arch Neurol. 1983; 40(8): 527-8.
  • 22. Wu Y, Wang T. Soybean lecithin fractionation and functionality. JAOCS. 2003; 80(4): 319-26.
  • 23. Droste JC, Jeraj HA, MacDonald A, Farrington K. Stability and in vitro efficacy of antibiotic-heparin lock solutions potentially useful for treatment of central venous catheter related sepsis. J Antimicrob Chemother. 2003; 51(4): 849-55. https://doi.org/10.1093/jac/dkg179.
  • 24. Aslam S, Trautner BW, Ramanathan V, Darouiche RO. Combination of tigecycline and N-acetylcysteine reduces biofilm-embedded bacteria on vascular catheters. Antimicrob Agents Chemother. 2007; 51(4): 1556-68. doi: 10.1128/AAC.00893-06.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Emel Mataracı Kara 0000-0003-4541-1893

Berna Özbek Çelik Bu kişi benim 0000-0001-8909-8398

Yayımlanma Tarihi 31 Ocak 2020
Gönderilme Tarihi 2 Ağustos 2019
Yayımlandığı Sayı Yıl 2020 Cilt: 10 Sayı: 1

Kaynak Göster

APA Mataracı Kara, E., & Özbek Çelik, B. (2020). Lesitin İçeren Antibiyotik Kilit Çözeltilerinin Klebsiella pneumoniae Biyofilmi Üzerine in vitro Etkileri. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 10(1), 94-99. https://doi.org/10.33631/duzcesbed.600413
AMA Mataracı Kara E, Özbek Çelik B. Lesitin İçeren Antibiyotik Kilit Çözeltilerinin Klebsiella pneumoniae Biyofilmi Üzerine in vitro Etkileri. DÜ Sağlık Bil Enst Derg. Ocak 2020;10(1):94-99. doi:10.33631/duzcesbed.600413
Chicago Mataracı Kara, Emel, ve Berna Özbek Çelik. “Lesitin İçeren Antibiyotik Kilit Çözeltilerinin Klebsiella Pneumoniae Biyofilmi Üzerine in Vitro Etkileri”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 10, sy. 1 (Ocak 2020): 94-99. https://doi.org/10.33631/duzcesbed.600413.
EndNote Mataracı Kara E, Özbek Çelik B (01 Ocak 2020) Lesitin İçeren Antibiyotik Kilit Çözeltilerinin Klebsiella pneumoniae Biyofilmi Üzerine in vitro Etkileri. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 10 1 94–99.
IEEE E. Mataracı Kara ve B. Özbek Çelik, “Lesitin İçeren Antibiyotik Kilit Çözeltilerinin Klebsiella pneumoniae Biyofilmi Üzerine in vitro Etkileri”, DÜ Sağlık Bil Enst Derg, c. 10, sy. 1, ss. 94–99, 2020, doi: 10.33631/duzcesbed.600413.
ISNAD Mataracı Kara, Emel - Özbek Çelik, Berna. “Lesitin İçeren Antibiyotik Kilit Çözeltilerinin Klebsiella Pneumoniae Biyofilmi Üzerine in Vitro Etkileri”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 10/1 (Ocak 2020), 94-99. https://doi.org/10.33631/duzcesbed.600413.
JAMA Mataracı Kara E, Özbek Çelik B. Lesitin İçeren Antibiyotik Kilit Çözeltilerinin Klebsiella pneumoniae Biyofilmi Üzerine in vitro Etkileri. DÜ Sağlık Bil Enst Derg. 2020;10:94–99.
MLA Mataracı Kara, Emel ve Berna Özbek Çelik. “Lesitin İçeren Antibiyotik Kilit Çözeltilerinin Klebsiella Pneumoniae Biyofilmi Üzerine in Vitro Etkileri”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, c. 10, sy. 1, 2020, ss. 94-99, doi:10.33631/duzcesbed.600413.
Vancouver Mataracı Kara E, Özbek Çelik B. Lesitin İçeren Antibiyotik Kilit Çözeltilerinin Klebsiella pneumoniae Biyofilmi Üzerine in vitro Etkileri. DÜ Sağlık Bil Enst Derg. 2020;10(1):94-9.