Pfaller Michael A, Huband Michael D, Rhomberg Paul R, Flamm Robert K
JMI Laboratories, North Liberty, Iowa, USA.
University of Iowa, Iowa City, Iowa, USA.
Antimicrob Agents Chemother. 2017 Apr 24;61(5). doi: 10.1128/AAC.00018-17. Print 2017 May.
Omadacycline is a broad-spectrum aminomethylcycline in late-stage clinical development for the treatment of acute bacterial skin and skin structure infections and community-acquired pneumonia as an oral and an intravenous once-daily formulation. In this study, omadacycline and comparators were tested against 69,246 nonduplicate bacterial isolates collected prospectively during 2010 and 2011 from medical centers in Asia-Pacific (11,397 isolates), Europe (23,490 isolates), Latin America (8,038 isolates), and North America (26,321 isolates). Omadacycline was tested by broth microdilution following Clinical and Laboratory Standards Institute M07-A10 (2015) methods. A total of 99.9% of isolates were inhibited by ≤2 μg/ml of omadacycline (MIC, 0.12/0.25 μg/ml), including 100.0% of methicillin-susceptible isolates and 99.8% of methicillin-resistant isolates. Omadacycline potencies were comparable for (MIC, 0.06/0.06 μg/ml), viridans group streptococci (MIC, 0.06/0.12 μg/ml), and beta-hemolytic streptococci (MIC, 0.06/0.12 μg/ml) regardless of species and susceptibility to penicillin. Omadacycline was active against and was most active against (MIC, 0.5/2 μg/ml), (MIC, 2/4 μg/ml), (MIC, 1/4 μg/ml), and spp. (MIC, 1/4 μg/ml). Omadacycline was active against (MIC, 1/1 μg/ml) regardless of β-lactamase status and against (MIC, 0.12/0.25 μg/ml). The potent activity of omadacycline against Gram-positive and Gram-negative bacteria indicates that omadacycline merits further study in serious infections in which multidrug resistance and mixed Gram-positive and Gram-negative infections may be a concern.
奥马环素是一种广谱氨基甲基环素,正处于临床开发后期,用于治疗急性细菌性皮肤和皮肤结构感染以及社区获得性肺炎,有口服和静脉注射两种每日一次的剂型。在本研究中,奥马环素和对照药物针对2010年和2011年期间从亚太地区(11397株分离菌)、欧洲(23490株分离菌)、拉丁美洲(8038株分离菌)和北美(26321株分离菌)的医疗中心前瞻性收集的69246株非重复细菌分离株进行了测试。奥马环素按照临床和实验室标准协会M07 - A10(2015年)方法通过肉汤微量稀释法进行测试。总共99.9%的分离株被≤2μg/ml的奥马环素抑制(MIC,0.12/0.25μg/ml),包括100.0%的甲氧西林敏感分离株和99.8%的甲氧西林耐药分离株。无论物种以及对青霉素的敏感性如何,奥马环素对肺炎链球菌(MIC,0.06/0. .06μg/ml)、草绿色链球菌(MIC,0.06/0.12μg/ml)和β溶血性链球菌(MIC,0.06/0.12μg/ml)的效力相当。奥马环素对金黄色葡萄球菌有活性,对耐甲氧西林金黄色葡萄球菌(MIC,0.5/2μg/ml)、表皮葡萄球菌(MIC,2/4μg/ml)、溶血葡萄球菌(MIC,1/4μg/ml)和腐生葡萄球菌属(MIC,1/4μg/ml)活性最强。无论β-内酰胺酶状态如何,奥马环素对肺炎克雷伯菌(MIC,1/1μg/ml)有活性,对大肠埃希菌(MIC,0.12/0.25μg/ml)有活性。奥马环素对革兰氏阳性菌和革兰氏阴性菌的强效活性表明,在多重耐药以及革兰氏阳性菌和革兰氏阴性菌混合感染可能是问题的严重感染中,奥马环素值得进一步研究。