Fratoni Andrew J, Padgett Alissa M, Duffy Erin M, Nicolau David P
Center for Anti-Infective Research and Development, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, USA.
CARB-X, Boston, MA, USA.
J Antimicrob Chemother. 2025 Jan 3;80(1):154-161. doi: 10.1093/jac/dkae388.
Preclinical murine infection models lack inter-laboratory uniformity, complicating result comparisons and data reproducibility. The European Innovative Medicines initiative-funded consortium (COMBINE) has developed a standardized murine neutropenic pneumonia protocol to address these concerns. While model methods have been standardized, a major obstacle to consistent results is the lack of available bacteria with defined viability and variability. Herein, we establish a diverse challenge set of Klebsiella pneumoniae and Pseudomonas aeruginosa suitable for use in the COMBINE protocol to further minimize experimental inconsistency and improve the interpretability of data generated among differing laboratories.
Sixty-six K. pneumoniae and 65 P. aeruginosa were phenotypically profiled against tigecycline (K. pneumoniae only), levofloxacin, meropenem, cefiderocol and tobramycin. Fifty-nine isolates were introduced into the COMBINE model to assess the sufficiency of the starting bacterial inoculation, resultant baseline bacterial burden, achievement of ≥1 log10cfu/lung growth at 24 h, time to and percentage mortality. Forty-five isolates displaying desirable minimum inhibitory concentration profiles were subjected to replicate in vivo testing to assess target parameters.
83% of K. pneumoniae reached the prerequisite growth at 24 h using a starting bacterial burden ≥7 log10cfu/lung. P. aeruginosa isolates grew well in the model: 90% achieved the growth target with a starting bacterial burden of 6 log10cfu/lung. Mortality was negligible for K. pneumoniae but high for P. aeruginosa. Poor or inconsistent achievement of the 24 h growth target was seen in 11/59 isolates.
With this diverse cache of viable isolates established in the COMBINE pneumonia model, future translational studies can be undertaken to set efficacy benchmarks among laboratories.
临床前小鼠感染模型缺乏实验室间的一致性,使得结果比较和数据可重复性变得复杂。由欧洲创新药物计划资助的联盟(COMBINE)已制定了标准化的小鼠中性粒细胞减少性肺炎方案,以解决这些问题。虽然模型方法已标准化,但获得一致结果的一个主要障碍是缺乏具有明确活力和变异性的可用细菌。在此,我们建立了一组适合用于COMBINE方案的肺炎克雷伯菌和铜绿假单胞菌的多样化挑战菌株,以进一步减少实验不一致性,并提高不同实验室间生成数据的可解释性。
对66株肺炎克雷伯菌和65株铜绿假单胞菌进行了针对替加环素(仅针对肺炎克雷伯菌)、左氧氟沙星、美罗培南、头孢地尔和妥布霉素的表型分析。将59株分离株引入COMBINE模型,以评估起始细菌接种量的充足性、由此产生的基线细菌负荷、24小时时达到≥1 log10cfu/肺生长的情况、死亡时间和死亡率百分比。对45株显示出理想最低抑菌浓度谱的分离株进行重复体内测试,以评估目标参数。
使用≥7 log10cfu/肺的起始细菌负荷时,83%的肺炎克雷伯菌在24小时时达到了前提生长。铜绿假单胞菌分离株在该模型中生长良好:90%的分离株在起始细菌负荷为6 log10cfu/肺时达到了生长目标。肺炎克雷伯菌的死亡率可忽略不计,但铜绿假单胞菌的死亡率很高。在59株分离株中有11株未达到或不一致地达到24小时生长目标。
通过在COMBINE肺炎模型中建立这一多样化的活菌分离株库,未来可以开展转化研究,以在各实验室间设定疗效基准。