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Original Research Article | OPEN ACCESS

Siamese crocodile plasma synergizes with ceftazidime against ceftazidime-resistant Enterobacter cloacae

Nitaya Rojtinnakorn1, Yosapong Temsiripong2, Thippawan Pimchan3, Griangsak Eumkeb1

1School of Preclinic; 2Sriracha Moda Farm, Sriracha District, Chonburi 20110, Thailand; 3School of Biology, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima, 3000.

For correspondence:-  Griangsak Eumkeb   Email: griang@sut.ac.th   Tel:+6644224260

Accepted: 17 January 2018        Published: 28 February 2018

Citation: Rojtinnakorn N, Temsiripong Y, Pimchan T, Eumkeb G. Siamese crocodile plasma synergizes with ceftazidime against ceftazidime-resistant Enterobacter cloacae. Trop J Pharm Res 2018; 17(2):307-317 doi: 10.4314/tjpr.v17i2.16

© 2018 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To evaluate whether Siamese crocodile plasma exhibits antibacterial properties and if it synergizes with ceftazidime against ceftazidime-resistant Enterobacter cloacae (CREnC).
Methods: Protein fractions were from crocodile plasma and tested them on CREnC strains. Multiplex polymerase chain reaction (PCR) screening test was performed for extended-spectrum β-lactamase (ESBL) phenotype and AmpC gene. The effects of the antibacterial agents were analyzed using a bacterial suspension standard curve, minimum inhibitory concentration (MIC), Checkerboard assays, viability curves, membrane permeability assays, enzyme assays, and transmission electron microscopy.
Results: CREnC strains expressed ESBL-AmpC gene combinations. The MICs of resuspended protein 1 (P1), protein 5 (P5), ceftazidime, cefotaxime, and benzylpenicillin against all tested CREnC and E. coli strains were in the range of > 1024 µg/mL, indicating resistance. However, P1 and P5 exhibited a synergistic effect against test CREnC and E. coli strains when used in combination with ceftazidime and cefotaxime, with fraction inhibitory concentration indices of < 0.062 and 0.28, respectively. A kill curve demonstrated that the combination treatments had synergistic activity and inhibited β-lactamase.
Conclusion: The synergistic activity of P1 and P5 in combination with ceftazidime is achieved in multiple ways, including increased cytoplasmic and outer membrane permeability, β-lactamase inhibition, and peptidoglycan damage. Therefore, the combination therapy of Siamese crocodile plasma and ceftazidime may be a novel therapeutic approach for treating recalcitrant E. cloacae infection

Keywords: Crocodylus siamensis, ceftazidime-resistant Enterobacter cloacae, synergistic activity, ^6;-lactamase activity

Impact Factor
Thompson Reuters (ISI): 0.523 (2021)
H-5 index (Google Scholar): 39 (2021)

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