Deolankar Manas S, Carr Rachel A, Fliorent Rebecca, Roh Sean, Fraimow Henry, Carabetta Valerie J
Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ 08103, USA.
Rowan School of Osteopathic Medicine, Stratford, NJ 08084, USA.
Antibiotics (Basel). 2022 Sep 23;11(10):1298. doi: 10.3390/antibiotics11101298.
For decades, the spread of multidrug-resistant (MDR) has been rampant in critically ill, hospitalized patients. Traditional antibiotic therapies against this pathogen have been failing, leading to rising concerns over management options for patients. Two new antibiotics, eravacycline and omadacycline, were introduced to the market and have shown promising results in the treatment of Gram-negative infections. Since these drugs are newly available, there is limited in vitro data about their effectiveness against MDR or even susceptible strains. Here, we examined the effectiveness of 22 standard-of-care antibiotics, eravacycline, and omadacycline against susceptible and extensively drug-resistant (XDR) patient isolates from Cooper University Hospital. Furthermore, we examined selected combinations of eravacycline or omadacycline with other antibiotics against an XDR strain. We demonstrated that this collection of strains is largely resistant to monotherapies of carbapenems, fluoroquinolones, folate pathway antagonists, cephalosporins, and most tetracyclines. While clinical breakpoint data are not available for eravacycline or omadacycline, based on minimum inhibitory concentrations, eravacycline was highly effective against these strains. The aminoglycoside amikacin alone and in combination with eravacycline or omadacycline yielded the most promising results. Our comprehensive characterization offers direction in the treatment of this deadly infection in hospitalized patients.
几十年来，多重耐药菌（MDR）在重症住院患者中传播猖獗。针对这种病原体的传统抗生素疗法一直失败，这引发了人们对患者治疗方案的日益担忧。两种新型抗生素，依拉环素和奥马环素，已投放市场，并在治疗革兰氏阴性菌感染方面显示出有前景的结果。由于这些药物是新上市的，关于它们对MDR甚至敏感菌株有效性的体外数据有限。在这里，我们检测了22种标准护理抗生素、依拉环素和奥马环素对库珀大学医院的敏感和广泛耐药（XDR）患者分离株的有效性。此外，我们检测了依拉环素或奥马环素与其他抗生素针对一种XDR菌株的选定组合。我们证明，这些菌株大多对碳青霉烯类、氟喹诺酮类、叶酸途径拮抗剂、头孢菌素类和大多数四环素类的单一疗法耐药。虽然依拉环素或奥马环素没有临床断点数据，但基于最低抑菌浓度，依拉环素对这些菌株非常有效。单独使用氨基糖苷类阿米卡星以及与依拉环素或奥马环素联合使用产生了最有前景的结果。我们的全面表征为住院患者这种致命感染的治疗提供了方向。
