Entasis Therapeutics, Waltham, Massachusetts, USA
Antimicrob Agents Chemother. 2017 Nov 22;61(12). doi: 10.1128/AAC.01612-17. Print 2017 Dec.
Sulbactam is one of four β-lactamase inhibitors in current clinical use to counteract drug resistance caused by degradation of β-lactam antibiotics by these bacterial enzymes. As a β-lactam itself, sulbactam is susceptible to degradation by β-lactamases. I investigated the Michaelis-Menten kinetics of sulbactam hydrolysis by 14 β-lactamases, representing clinically widespread groups within all four Ambler classes, i.e., CTX-M-15, KPC-2, SHV-5, and TEM-1 for class A; IMP-1, NDM-1, and VIM-1 for class B; ADC-7, AmpC, and P99 for class C; and OXA-10, OXA-23, OXA-24, and OXA-48 for class D. All of the β-lactamases were able to hydrolyze sulbactam, although they varied widely in their kinetic constants for the reaction, even within each class. I also investigated the inactivation kinetics of the inhibition of these enzymes by sulbactam. The class A β-lactamases varied widely in their susceptibility to inhibition, the class C and D enzymes were very weakly inhibited, and the class B enzymes were essentially or completely unaffected. In addition, we measured the sulbactam turnover number, the sulbactam/enzyme molar ratio required for complete inhibition of each enzyme. Class C enzymes had the lowest turnover numbers, class A enzymes varied widely, and class D enzymes had very high turnover numbers. These results are valuable for understanding which β-lactamases ought to be well inhibited by sulbactam. Moreover, since sulbactam has intrinsic antibacterial activity against species pathogens, these results contribute to understanding β-lactamase-mediated sulbactam resistance in , especially due to the action of the widespread class D enzymes.
舒巴坦是目前临床使用的四种β-内酰胺酶抑制剂之一,用于抵抗这些细菌酶对β-内酰胺抗生素的降解所导致的药物耐药性。作为一种β-内酰胺,舒巴坦本身容易被β-内酰胺酶降解。我研究了 14 种β-内酰胺酶对舒巴坦水解的米氏动力学,这些酶代表了所有四个 Ambler 类别的临床广泛群体,即 CTX-M-15、KPC-2、SHV-5 和 TEM-1 为 A 类;IMP-1、NDM-1 和 VIM-1 为 B 类;ADC-7、AmpC 和 P99 为 C 类;以及 OXA-10、OXA-23、OXA-24 和 OXA-48 为 D 类。所有的β-内酰胺酶都能够水解舒巴坦,尽管它们在反应的动力学常数上差异很大,甚至在每个类别内也是如此。我还研究了这些酶被舒巴坦抑制的失活动力学。A 类β-内酰胺酶对抑制的敏感性差异很大,C 类和 D 类酶的抑制作用很弱,而 B 类酶基本上或完全不受影响。此外,我们测量了舒巴坦的周转数,即每个酶完全抑制所需的舒巴坦/酶摩尔比。C 类酶的周转数最低,A 类酶差异很大,D 类酶的周转数非常高。这些结果对于理解哪些β-内酰胺酶应该被舒巴坦很好地抑制是有价值的。此外,由于舒巴坦对 种病原体具有内在的抗菌活性,这些结果有助于理解β-内酰胺酶介导的舒巴坦耐药性,尤其是由于广泛存在的 D 类酶的作用。