Antimicrobial activity of antibiotics in combination with natural flavonoids against clinical extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Extended-spectrum β-lactamases (ESBLs) are plasmid-mediated class A enzymes commonly found in the family Enterobacteriaceae, mainly in Klebsiella pneumoniae. Flavonoids have also been reported to possess antimicrobial activity. In this study, the in vitro activities of 18 antibiotics and 12 flavonoids against 20 ESBL-producing K. pneumoniae isolates were evaluated. All of these isolates were susceptible to imipenem and cefinetazole, but were resistant to ampicillin, ampicillin/sulbactam, aztreonam, cefazolin, cefoperazone, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, piperacillin and ticarcillin. Susceptibilities to amikacin, amoxicillin/clavulanate, cefoxitin, ciprofloxacin and gentamicin were variable. Myricetin, a flavonol, inhibited ESBL-producing K. pneumoniae isolates at a high minimum inhibitory concentration (MIC) (MIC90 value 256 mg/mL), but exhibited significant synergic activity against ESBL-producing K. pneumoniae in separate combination with amoxicillin/clavulanate, ampicillin/sulbactam and cefoxitin. Because of the low-toxic nature of flavonoids, the combination of antibiotics and flavonoids is a potential new strategy for developing therapies for infections caused by ESBL-producing bacteria in the future.

Original languageEnglish
Pages (from-to)612-617
Number of pages6
JournalPhytotherapy Research
Volume19
Issue number7
DOIs
Publication statusPublished - Jul 2005

Fingerprint

Klebsiella pneumoniae
Flavonoids
Anti-Bacterial Agents
Cefoxitin
Clavulanic Acid
Amoxicillin
Ticarcillin
Aztreonam
Cefoperazone
Cefazolin
Cefuroxime
Piperacillin
Ceftazidime
Amikacin
Cefotaxime
Ceftriaxone
Imipenem
Poisons
Microbial Sensitivity Tests
Enterobacteriaceae

Keywords

  • Amoxicillin/clavulanate
  • Ampicillin/sulbactam
  • Cefoxitin
  • Myricetin
  • Time-kill curves

ASJC Scopus subject areas

  • Drug Discovery
  • Organic Chemistry
  • Pharmacology

Cite this

@article{e4f521fe395c47278121a9c6641c6e8d,
title = "Antimicrobial activity of antibiotics in combination with natural flavonoids against clinical extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae",
abstract = "Extended-spectrum β-lactamases (ESBLs) are plasmid-mediated class A enzymes commonly found in the family Enterobacteriaceae, mainly in Klebsiella pneumoniae. Flavonoids have also been reported to possess antimicrobial activity. In this study, the in vitro activities of 18 antibiotics and 12 flavonoids against 20 ESBL-producing K. pneumoniae isolates were evaluated. All of these isolates were susceptible to imipenem and cefinetazole, but were resistant to ampicillin, ampicillin/sulbactam, aztreonam, cefazolin, cefoperazone, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, piperacillin and ticarcillin. Susceptibilities to amikacin, amoxicillin/clavulanate, cefoxitin, ciprofloxacin and gentamicin were variable. Myricetin, a flavonol, inhibited ESBL-producing K. pneumoniae isolates at a high minimum inhibitory concentration (MIC) (MIC90 value 256 mg/mL), but exhibited significant synergic activity against ESBL-producing K. pneumoniae in separate combination with amoxicillin/clavulanate, ampicillin/sulbactam and cefoxitin. Because of the low-toxic nature of flavonoids, the combination of antibiotics and flavonoids is a potential new strategy for developing therapies for infections caused by ESBL-producing bacteria in the future.",
keywords = "Amoxicillin/clavulanate, Ampicillin/sulbactam, Cefoxitin, Myricetin, Time-kill curves",
author = "Lin, {Rong Dih} and Chin, {Yi Ping} and Lee, {Mei Hsien}",
year = "2005",
month = "7",
doi = "10.1002/ptr.1695",
language = "English",
volume = "19",
pages = "612--617",
journal = "Phytotherapy Research",
issn = "0951-418X",
publisher = "John Wiley and Sons Ltd",
number = "7",

}

TY - JOUR

T1 - Antimicrobial activity of antibiotics in combination with natural flavonoids against clinical extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae

AU - Lin, Rong Dih

AU - Chin, Yi Ping

AU - Lee, Mei Hsien

PY - 2005/7

Y1 - 2005/7

N2 - Extended-spectrum β-lactamases (ESBLs) are plasmid-mediated class A enzymes commonly found in the family Enterobacteriaceae, mainly in Klebsiella pneumoniae. Flavonoids have also been reported to possess antimicrobial activity. In this study, the in vitro activities of 18 antibiotics and 12 flavonoids against 20 ESBL-producing K. pneumoniae isolates were evaluated. All of these isolates were susceptible to imipenem and cefinetazole, but were resistant to ampicillin, ampicillin/sulbactam, aztreonam, cefazolin, cefoperazone, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, piperacillin and ticarcillin. Susceptibilities to amikacin, amoxicillin/clavulanate, cefoxitin, ciprofloxacin and gentamicin were variable. Myricetin, a flavonol, inhibited ESBL-producing K. pneumoniae isolates at a high minimum inhibitory concentration (MIC) (MIC90 value 256 mg/mL), but exhibited significant synergic activity against ESBL-producing K. pneumoniae in separate combination with amoxicillin/clavulanate, ampicillin/sulbactam and cefoxitin. Because of the low-toxic nature of flavonoids, the combination of antibiotics and flavonoids is a potential new strategy for developing therapies for infections caused by ESBL-producing bacteria in the future.

AB - Extended-spectrum β-lactamases (ESBLs) are plasmid-mediated class A enzymes commonly found in the family Enterobacteriaceae, mainly in Klebsiella pneumoniae. Flavonoids have also been reported to possess antimicrobial activity. In this study, the in vitro activities of 18 antibiotics and 12 flavonoids against 20 ESBL-producing K. pneumoniae isolates were evaluated. All of these isolates were susceptible to imipenem and cefinetazole, but were resistant to ampicillin, ampicillin/sulbactam, aztreonam, cefazolin, cefoperazone, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, piperacillin and ticarcillin. Susceptibilities to amikacin, amoxicillin/clavulanate, cefoxitin, ciprofloxacin and gentamicin were variable. Myricetin, a flavonol, inhibited ESBL-producing K. pneumoniae isolates at a high minimum inhibitory concentration (MIC) (MIC90 value 256 mg/mL), but exhibited significant synergic activity against ESBL-producing K. pneumoniae in separate combination with amoxicillin/clavulanate, ampicillin/sulbactam and cefoxitin. Because of the low-toxic nature of flavonoids, the combination of antibiotics and flavonoids is a potential new strategy for developing therapies for infections caused by ESBL-producing bacteria in the future.

KW - Amoxicillin/clavulanate

KW - Ampicillin/sulbactam

KW - Cefoxitin

KW - Myricetin

KW - Time-kill curves

UR - http://www.scopus.com/inward/record.url?scp=25444486966&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=25444486966&partnerID=8YFLogxK

U2 - 10.1002/ptr.1695

DO - 10.1002/ptr.1695

M3 - Article

C2 - 16161024

AN - SCOPUS:25444486966

VL - 19

SP - 612

EP - 617

JO - Phytotherapy Research

JF - Phytotherapy Research

SN - 0951-418X

IS - 7

ER -