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Bactericidal efficacy of meropenem in combination with cefmetazole against IMP-producing carbapenem-resistant

Ryuichiro Abe1,2,3, Hideharu Hagiya4,5, Yukihiro Akeda1,2

  • 1Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan.

BMC Research Notes
|November 11, 2019
PubMed
Abstract

Insights

Combination therapy with meropenem (MEM) and cefmetazole (CMZ) showed synergistic and bactericidal effects against carbapenem-resistant Enterobacteriaceae (CRE) producing Imipenemase (IMP) in vitro. This novel combination warrants further investigation for clinical use.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Carbapenem-resistant Enterobacteriaceae (CRE) pose a significant global health threat due to extensive antibiotic resistance.
  • Imipenemase (IMP)-producing CRE are particularly challenging to treat with existing antibiotics.

Purpose of the Study:

  • To evaluate the in vitro efficacy of a combination therapy using meropenem (MEM) and cefmetazole (CMZ) against IMP-producing CRE.
  • To assess the synergistic and bactericidal potential of MEM/CMZ against specific strains of Enterobacteriaceae harboring blaIMP-1 and blaIMP-6.

Main Methods:

  • Utilized the checkerboard method to determine synergistic effects of MEM/CMZ.
  • Employed time-killing assays to assess bactericidal activity.
  • Tested 26 IMP-producing CRE isolates, including Enterobacter hormaechei, Escherichia coli, and Klebsiella pneumoniae.

Main Results:

  • The MEM/CMZ combination demonstrated synergy against all tested IMP-producing CRE isolates.
  • Time-kill assays confirmed a bactericidal effect for both blaIMP-1 and blaIMP-6 positive CRE.
  • In vitro results suggest potential efficacy of MEM/CMZ against IMP-1- or IMP-6-producing CRE.

Conclusions:

  • The MEM/CMZ combination therapy shows promise as an effective treatment against IMP-producing CRE in vitro.
  • Further in vivo and clinical studies are necessary to validate the therapeutic potential of this combination.
  • This research contributes to the development of novel strategies to combat multidrug-resistant infections.
Keywords:
Carbapenem-resistant EnterobacteriaceaeCarbapenemase-producing EnterobacteriaceaCefmetazoleCephamycinIMP

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