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针对多药耐药铜绿假单胞菌菌株的治疗性测试的经过验证的临床前小鼠模型。

Validated Preclinical Mouse Model for Therapeutic Testing against Multidrug-Resistant Pseudomonas aeruginosa Strains.

机构信息

Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisvillegrid.266623.5, Louisville, Kentucky, USA.

Department of Microbiology and Immunology, University of Louisvillegrid.266623.5 School of Medicine, Louisville, Kentucky, USA.

出版信息

Microbiol Spectr. 2022 Oct 26;10(5):e0269322. doi: 10.1128/spectrum.02693-22. Epub 2022 Sep 12.

Abstract

The rise in infections caused by antibiotic-resistant bacteria is outpacing the development of new antibiotics. The ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) are a group of clinically important bacteria that have developed resistance to multiple antibiotics and are commonly referred to as multidrug resistant (MDR). The medical and research communities have recognized that, without new antimicrobials, infections by MDR bacteria will soon become a leading cause of morbidity and death. Therefore, there is an ever-growing need to expedite the development of novel antimicrobials to combat these infections. Toward this end, we set out to refine an existing mouse model of pulmonary Pseudomonas aeruginosa infection to generate a robust preclinical tool that can be used to rapidly and accurately predict novel antimicrobial efficacy. This refinement was achieved by characterizing the virulence of a panel of genetically diverse MDR P. aeruginosa strains in this model, by both 50% lethal dose (LD) analysis and natural history studies. Further, we defined two antibiotic regimens (aztreonam and amikacin) that can be used as comparators during the future evaluation of novel antimicrobials, and we confirmed that the model can effectively differentiate between successful and unsuccessful treatments, as predicted by inhibitory data. This validated model represents an important tool in our arsenal to develop new therapies to combat MDR P. aeruginosa strains, with the ability to provide rapid preclinical evaluation of novel antimicrobials and support data from clinical studies during the investigational drug development process. The prevalence of antibiotic resistance among bacterial pathogens is a growing problem that necessitates the development of new antibiotics. Preclinical animal models are important tools to facilitate and speed the development of novel antimicrobials. Successful outcomes in animal models not only justify progression of new drugs into human clinical trials but also can support FDA decisions if clinical trial sizes are small due to a small population of infections with specific drug-resistant strains. However, in both cases the preclinical animal model needs to be well characterized and provide robust and reproducible data. Toward this goal, we have refined an existing mouse model to better predict the efficacy of novel antibiotics. This improved model provides an important tool to better predict the clinical success of new antibiotics.

摘要

抗生素耐药菌引起的感染不断增加,超过了新抗生素的研发速度。ESKAPE 病原体(屎肠球菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和肠杆菌属)是一组临床上重要的细菌,它们已经对多种抗生素产生了耐药性,通常被称为多药耐药(MDR)。医学和研究界已经认识到,如果没有新的抗菌药物,MDR 细菌引起的感染将很快成为发病率和死亡率的主要原因。因此,迫切需要加快新型抗菌药物的开发,以对抗这些感染。为此,我们着手改进现有的肺部铜绿假单胞菌感染小鼠模型,以生成一种强大的临床前工具,用于快速准确地预测新型抗菌药物的疗效。通过对该模型中一组遗传上多样化的 MDR 铜绿假单胞菌菌株的毒力进行 50%致死剂量(LD)分析和自然史研究,实现了这一改进。此外,我们确定了两种抗生素方案(氨曲南和阿米卡星),可在未来评估新型抗菌药物时用作对照,并确认该模型可有效区分成功和失败的治疗,正如抑制数据所预测的那样。该验证模型是我们开发新疗法对抗 MDR 铜绿假单胞菌菌株的重要工具之一,具有提供新型抗菌药物快速临床前评估的能力,并支持药物开发过程中临床研究的数据。

细菌病原体对抗生素的耐药性日益严重,这需要开发新的抗生素。临床前动物模型是促进和加速新型抗菌药物研发的重要工具。动物模型的成功结果不仅证明了新药物进入人体临床试验的合理性,而且如果由于特定耐药菌株感染的人群较小,临床试验规模较小,还可以支持 FDA 的决策。然而,在这两种情况下,临床前动物模型都需要进行很好的特征描述,并提供稳健和可重复的数据。为此,我们改进了现有的小鼠模型,以更好地预测新型抗生素的疗效。这种改进后的模型为更好地预测新型抗生素的临床疗效提供了重要工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12db/9603883/aec26ea3c302/spectrum.02693-22-f001.jpg

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