Mataracı Kara, EmelYılmaz, MesutÖzbek Çelik, Berna2020-10-262020-10-262020Mataracı Kara, E., Yılmaz, M. ve Özbek Çelik, B. (2020). In vitro synergistic effect and mutant prevention concentrations of cefepime alone or in combination with sulbactam against OXA-48-positiveKlebsiella pneumoniaeIsolates. Current Microbiology, 77(9), 2137-2142. https://dx.doi.org/10.1007/s00284-020-02094-00343-86511432-0991https://dx.doi.org/10.1007/s00284-020-02094-0https://hdl.handle.net/20.500.12511/5968The aim of this study is to investigate the combination of cefepime and sulbactam. Sulbactam, when administered , will effectively inhibit all Extended-spectrum beta lactamases (ESBLs) of the microorganism, while cefepime will inhibit the growth of the resistant microorganisms since it will not be hydrolyzed by OXA-48. Forty OXA-48-producingK. pneumoniaestrains were investigated for their Minimum inhibitory concentrations (MICs) for carbapenems, cefepime, and cefepime + sulbactam by broth microdilution method. Also, the mutant prevention concentration (MPC)s of cefepime alone or in combination with sulbactam was determined. Additionally, the bactericidal activities of cefepime and cefepime + sulbactam were evaluated by the time-kill curve (TKC) assay against selected strains. Also, the in vitro synergistic activity of cefepime + sulbactam combination was determined by TKC. Based on MIC results, up to 35/40 and 34/40 of the strains were resistant to carbapenems and cefepime, respectively. Cefepime + sulbactam MIC range was lower than those for cefepime alone against all the studied isolates. Moreover, cefepime + sulbactam combination presented lower MPC values than cefepime alone. The synergistic interactions of cefepime + sulbactam were also achieved against studied strains at 24 h. No antagonism was observed against studiedK. pneumoniaestrains. The findings of this study displayed that cefepime + sulbactam combination had synergistic or additive effect against OXA-48-producingK. pneumoniaestrains. Additionally, it was first observed that this combination could display a lower MPC than cefepime alone. Further investigations may be helpful for understanding the effectiveness of cefepime + sulbactam combinations for OXA-48-positive carbapenem-resistantK. pneumoniaeisolates.eninfo:eu-repo/semantics/embargoedAccessOXA-48-positiveKlebsiellaSulbactam AgainstCefepime AloneArticle7792137214210.1007/s00284-020-02094-0Q4Q2