JMI Laboratories, North Liberty, IA, USA.
JMI Laboratories, North Liberty, IA, USA; University of Iowa, Iowa City, IA, USA.
J Glob Antimicrob Resist. 2019 Dec;19:56-63. doi: 10.1016/j.jgar.2019.02.017. Epub 2019 Feb 27.
Omadacycline is an aminomethylcycline antibacterial (oral and intravenous once-daily formulation) that recently (October 2018) received United States Food and Drug Administration (FDA) approval for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) and community-acquired bacterial pneumonia (CABP) against selected organism groups. This study tested omadacycline and comparators against 14 000 non-duplicate bacterial isolates that were prospectively collected during 2017 from medical centres in Europe (EUR; 7000 isolates) and the United States (USA; 7000 isolates).
Omadacycline was tested by broth microdilution following Clinical and Laboratory Standards Institute M07-A11 (2018) methods.
A total of 98.7% ofStaphylococcus aureus isolates were susceptible to omadacycline (MIC, 0.12/0.25mg/L; ABSSSI breakpoints) including 96.5% of methicillin-resistant Staphylococcus aureus (MRSA), 99.8% of methicillin-susceptible Staphylococcus aureus, and 93.9% of tetracycline-resistant strains. Omadacycline activity was similar for Streptococcus pneumoniae (MIC 0.06/0.12mg/L; 98.6% susceptible [CABP breakpoints]), Streptococcus anginosus group (MIC 0.06/0.06mg/L; 100.0% susceptible [ABSSSI breakpoints]), and Streptococcus pyogenes (MIC 0.06/0.12mg/L; 97.7% susceptible [ABSSSI breakpoints]). Omadacycline demonstrated activity against Enterobacter cloacae species complex isolates (MIC, 2/4mg/L; 91.2% susceptible [ABSSSI breakpoints]), Klebsiella pneumoniae (MIC, 2/8mg/L; 87.5% susceptible [CABP and ABSSSI breakpoints]), and inhibited 99.1% of Escherichia coli (MIC, 0.5/2mg/L) isolates at ≤ 4mg/L. Omadacycline was active against Haemophilus influenzae (MIC, 0.5/1mg/L; 99.8% susceptible [CABP breakpoints]), including all β-lactamase positive isolates, and inhibited 100.0% of Moraxella catarrhalis isolates at ≤ 0.25mg/L.
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 of concern.
奥马环素是一种氨基甲基环素类抗菌药物（口服和静脉注射，每日一次），最近（2018 年 10 月）获得美国食品和药物管理局（FDA）批准，用于治疗特定病原体引起的急性细菌性皮肤和皮肤结构感染（ABSSSIs）和社区获得性细菌性肺炎（CABP）。本研究检测了奥马环素和对照药物对 2017 年期间在欧洲（EUR；7000 株）和美国（USA；7000 株）的医疗中心前瞻性收集的 14000 株非重复细菌分离株的作用。
采用临床和实验室标准协会 M07-A11（2018）方法进行肉汤微量稀释法检测奥马环素。
金黄色葡萄球菌分离株中 98.7%对奥马环素敏感（MIC，0.12/0.25mg/L；ABSSSI 折点），包括 96.5%耐甲氧西林金黄色葡萄球菌（MRSA）、99.8%甲氧西林敏感金黄色葡萄球菌和 93.9%四环素耐药株。肺炎链球菌的奥马环素活性相似（MIC0.06/0.12mg/L；98.6%敏感[CABP 折点]）、酿脓链球菌组（MIC0.06/0.06mg/L；100.0%敏感[ABSSSI 折点]）和化脓性链球菌（MIC0.06/0.12mg/L；97.7%敏感[ABSSSI 折点]）。奥马环素对阴沟肠杆菌属复合种分离株（MIC，2/4mg/L；91.2%敏感[ABSSSI 折点]）、肺炎克雷伯菌（MIC，2/8mg/L；87.5%敏感[CABP 和 ABSSSI 折点]）和 99.1%的大肠埃希菌（MIC，0.5/2mg/L）分离株具有活性，在≤4mg/L 时抑制率达 99.1%。奥马环素对流感嗜血杆菌（MIC，0.5/1mg/L；99.8%敏感[CABP 折点]），包括所有β-内酰胺酶阳性分离株均具有活性，对≤0.25mg/L 的卡他莫拉菌分离株的抑制率为 100.0%。
奥马环素对革兰氏阳性和革兰氏阴性细菌的强大活性表明，奥马环素在严重感染中值得进一步研究，这些感染可能存在多药耐药和混合革兰氏阳性和革兰氏阴性感染的问题。
