The Cytotoxicity Effect Study of Fosfomycin and Mecillinam Antibiotic on Multi-Drug Resistant Klebsiella pneumoniae from Infected Urothelial Tissue

Abstract

Enterobacteriaceae bacteria are clinically important and lead to various diseases associated with high mortality and morbidity, including urinary tract infections, yet their treatment is a challenge due to increasing antibiotic resistance. This study examined the cytotoxicity effects and viability-inducing abilities of mecillinam and fosfomycin antibiotics in the extended-spectrum beta-lactamase Klebsiella pneumoniae strain. The immortalized normal human urothelial cell line was used and the urothelial cell line and bacteria using Klebsiella pneumoniae cultures were prepared. The bacterial association assays with the urothelial cell line were then conducted. The cytotoxic effects were examined using cytotoxicity assays of Klebsiella pneumoniae, cefotaxime-Munich, ampicillinase C, oxacillinase and transmission electron microscopy on the immortalized normal human urothelial cell line. The cytotoxicity of fosfomycin and mecillinam on cell line cytotoxic assays were measured by lactate dehydrogenase, a cell death marker and visualized by hematoxylin. Klebsiella pneumoniae strains showed significantly reduced association with urothelial cells than cefotaxime-Munich strains. The cefotaxime-Munich and ampicillinase C had a higher association with the urothelial cells than the oxacillinase and transmission electron microscopy strains. The cytotoxicity assays indicated that all Klebsiella pneumoniae strains had increased cytotoxicity after 24 or 12 h of incubation. Antibiotic resistance is increased by the bacterial strains that have genes encoding resistance, such as cefotaxime-Munich, ampicillinase C, transmission electron microscopy and oxacillinase.