Investigation of Synergistic Effects of Curcumin with Some Antibiotics in Extended Spectrum Beta Lactamase Positive Or Negative Escherichia Coli and Klebsiella Pneumoniae Isolates

Abstract

Introduction: In recent years resistance against some antibiotics, particularly carbapenems, one of the first options for treatment, has increased among extended spectrum beta lactamase (ESBL) producing E. coli and K. pneumoniae isolates. In this study. the influence of curcumin on amikacin, gentamycin, imipenem and ciprofloxacine minimum inhibitory concentration (MIC) values of ESBL positive and negative E. coli or K. pneumoniae isolates, was investigated. Methods: For this purpose, a total of 63 Escherichia coli (30 ESBL + and 33 ESBL -) and 22 K. pneumoniae isolates (10 ESBL + and 12 ESBL -) were included in the study. MIC values of bacteria were determined with microdilution method according to Clinical and Laboratory Standards Institute (CLSI) recommendations. Synergistic effect of curcumin was studied with checkerboard method. Results: In both bacteria groups, ESBL + isolates were found to be more resistant against all tested antibiotics compared to ESBL - ones. Curcumin was detected not to have a synergistic effect with amikacin, gentamycin and ciprofloxacin in low and high concentrations. Curcumin/imipenem combination was determined to reduce MIC values of imipenem in all ESBL + and ESBL - E. coli and K. pneumoniae isolates resistant to imipenem and brought MIC values to susceptible limits. Conclusion: In conclusion, curcumin may be combined with carbapenems in severe infections caused by ESBL + E. coli and K. pneumoniae isolates, as its bioavailability is good and well tolerated in therapeutic concentrations.