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

Yıl 2020, Cilt: 10 Sayı: 1, 94 - 99, 31.01.2020

Emel Mataracı Kara , Berna Özbek Çelik

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.

Anahtar Kelimeler

Catheter infections, biofilm, antimicrobial lock therapy, lecithin, Klebsiella pneumoniae

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

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.

Anahtar Kelimeler

Kateter enfeksiyonları, biyofilm, antibiyotik kilit tedavisi, lesitin, Klebsiella pneumoniae

Kaynakça

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