Göknur YAPAR, Özlem Kurt AZAP, Ünal ÇAĞIR, Hande ARSLAN, Funda TİMURKAYNAK

In virto synergy between glycopeptides and carbapenems against methicillin-resistant staphylococcus aureus

Giriş: Glikopeptidler, metisiline-dirençli Staphylococcus aureus suşlanmn tedavisinde son 30 yıldır kullanılmaktadır. Glikopeptidlere duyarlılığı azalmış stafilokok suşlarm ortaya çıkmasıyla alternatif tedavilere gereksinim duyulmaya başlanmıştır. Bilinen antibiyotiklerin kombine kullanılması, yeni antibiyotiklere alternatif bir yaklaşım getirebilir. Bu çalışmanın amacı, glikopeptidlerle karbapenem kombinasyonunu ve glikopeptidlerle sefepim kombinasyonunun in vitro etkinliğini araştırmaktır. Gereç ve Yöntem: Çalışmaya toplam 30 MRSA susu alınmıştır. Vankomisinimipenem (VA-IPM), vankomisinmeropenem (VA-MEM), teikoplaninimipenem (TEC-IPM), teikoplanin meropenem (TEC-MEM), vankomismsefepim (VA-FEP), teikoplaninsefepim (TEC-FEP) kombinasyonlarının sinerjik etkinliğinin araştırılması amacıyla E-test stripleri kullanılmıştır. Bulgular: VA-IPM, VA-MEM kombinasyonları için 30 susun 19'unda, TEC-IPM ve TEC-MEM kombinasyonları için 30 susun 25'inde in vitro sinerjik etki olduğu görülmüştür. VA-FEP kombinasyonu, 19 suş için, TECFEP kombinasyonu da 21 suş için sinerjik bulunmuştur. Sonuç: Sorunlu infeksiyonlarm tedavisinde kombinasyon tedavisi yeni antibiyotiklere alternatif olabilir.

Metisiline-diençli staphylococcus aureus suşlarında glikopeptidlerin ve karbapenemlerin in vitrosinerjik etkisinin araştırılması

Introduction: Glycopeptides have been used in the treatment of methicillinresistant Staphylococcus aureus infections for the last 30 years. However, the emergence of staphylococcal isolates with reduced susceptibility to glycopeptides necessitates alternative therapies. A combination of wellknown antibiotics may be an alternative approach to new drugs. The aim of this study was to investigate the synergy between glycopeptides and carbapenems, and glycopeptides and cefepime and whether there is any discrepancy between them. Materials and Methods: A total of 30 MRSA isolates were studied. An E-test was performed to investigate the synergy of vancomycin-imipenem (VA-IPM), vancomycin-meropenem (VA-MEM), teicoplanin-imipenem (TEC-IPM), teicoplanin-meropenem (TEC-MEM), vancomycin-cefepime (VA-FEP), and teicoplanin-cefepime (TEC-FEP) combinations. Results: Synergy was detected in 19 and 25 of the 30 strains for the VA-IPM and VA-MEM, and TEC-IPM and TEC-MEM combinations, respectively. VA-FEP synergy was detected in 19, and TEC-FEP synergy was detected in the 21 of the isolates. Conclusion: Combination therapy may be an alternative to new drugs in the treatment of MRSA infections since in vitro studies provide promising results.

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