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Gong F, Chen Z, Chang J, Liu J, Wang X, Mo W, Tan M, Jiang T. Metagenomic Next-Generation Sequencing Contributes to the Diagnosis of Pneumonia Caused by Chlamydia abortus in a Male Patient: Case Report and Literature Review. Infect Drug Resist 2023; 16:3463-3468. [PMID: 37293537 PMCID: PMC10244205 DOI: 10.2147/idr.s407741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/23/2023] [Indexed: 06/10/2023] Open
Abstract
Background Chlamydia abortus is generally considered as the main cause of ruminants abortion, but it rarely causes human infection resulting in abortion or pneumonia. Case Presentation We report a case of male patient with pneumonia caused by Chlamydia abortus. Results of next generation sequencing (NGS) in the bronchoalveolar lavage fluid (BALF) indicated Chlamydia abortus infection. The patient was treated with intravenous infusion of doxycycline. The clinical symptoms of this patient were ameliorated significantly, and all these improvement were indicated by laboratory parameters significantly. Shown as chest computed tomography (CT), most of the inflammation had been absorbed after doxycycline treatment. Conclusion Chlamydia abortus mainly infects ruminants and occasionally humans. NGS has its own advantages of rapidity, sensitivity and specificity in detecting Chlamydia abortus. Doxycycline exhibits a great therapeutic effect on pneumonia caused by Chlamydia abortus.
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Affiliation(s)
- Fan Gong
- Department of Emergency Medicine, Hunan University of Medicine General Hospital, Huaihua, 418000, People’s Republic of China
| | - Zhikui Chen
- Department of Respiratory Medicine, Hunan University of Medicine General Hospital, Huaihua, 418000, People’s Republic of China
| | - Jianyuan Chang
- Department of Emergency Medicine, Hunan University of Medicine General Hospital, Huaihua, 418000, People’s Republic of China
| | - Jinlong Liu
- Department of Respiratory Medicine, Hunan University of Medicine General Hospital, Huaihua, 418000, People’s Republic of China
| | - Xiaobin Wang
- Department of Emergency Medicine, Hunan University of Medicine General Hospital, Huaihua, 418000, People’s Republic of China
| | - Weisong Mo
- Department of Emergency Medicine, Hunan University of Medicine General Hospital, Huaihua, 418000, People’s Republic of China
| | - Mengqin Tan
- Department of Emergency Medicine, Hunan University of Medicine General Hospital, Huaihua, 418000, People’s Republic of China
| | - Tao Jiang
- Department of Emergency Medicine, Hunan University of Medicine General Hospital, Huaihua, 418000, People’s Republic of China
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Kaur R, Rani P, Atanasov AG, Alzahrani Q, Gupta R, Kapoor B, Gulati M, Chawla P. Discovery and Development of Antibacterial Agents: Fortuitous and Designed. Mini Rev Med Chem 2021; 22:984-1029. [PMID: 34939541 DOI: 10.2174/1570193x19666211221150119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 11/22/2022]
Abstract
Today, antibacterial drug resistance has turned into a significant public health issue. Repeated intake, suboptimal and/or unnecessary use of antibiotics, and, additionally, the transfer of resistance genes are the critical elements that make microorganisms resistant to conventional antibiotics. A substantial number of antibacterials that were successfully utilized earlier for prophylaxis and therapeutic purposes have been rendered inadequate due to this phenomenon. Therefore, the exploration of new molecules has become a continuous endeavour. Many such molecules are at various stages of investigation. A surprisingly high number of new molecules are currently in the stage of phase 3 clinical trials. A few new agents have been commercialized in the last decade. These include solithromycin, plazomicin, lefamulin, omadacycline, eravacycline, delafloxacin, zabofloxacin, finafloxacin, nemonoxacin, gepotidacin, zoliflodacin, cefiderocol, BAL30072, avycaz, zerbaxa, vabomere, relebactam, tedizolid, cadazolid, sutezolid, triclosan and afabiacin. This article aims to review the investigational and recently approved antibacterials with a focus on their structure, mechanisms of action/resistance, and spectrum of activity. Delving deep, their success or otherwise in various phases of clinical trials is also discussed while attributing the same to various causal factors.
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Affiliation(s)
- Ravleen Kaur
- Department of Health Sciences, Cape Breton University, Sydney, Nova Scotia. Canada
| | - Pooja Rani
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara. India
| | - Atanas G Atanasov
- Ludwig Boltzmann Institute of Digital Health and Patient Safety, Medical University of Vienna, Vienna. Austria
| | - Qushmua Alzahrani
- Department of Pharmacy/Nursing/Medicine Health and Environment, University of the Region of Joinville (UNIVILLE) volunteer researcher, Joinville. Brazil
| | - Reena Gupta
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara . India
| | - Bhupinder Kapoor
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara . India
| | - Monica Gulati
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara . India
| | - Pooja Chawla
- Department of Pharmaceutical Chemistry and Analysis, ISF College of Pharmacy, Ghal Kalan Moga, Punjab 142001. India
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Papa V, Ginocchietti L, Budriesi R, Micucci M, Costa R, Biondi R, Cevenini R, Chiarini A, Aldini R, Donati M, Pollini GM, Cenacchi G. In vitro activity of a partially purified and characterized bark extract of Castanea sativa Mill. (ENC®) against Chlamydia spp. Ultrastruct Pathol 2017; 41:147-153. [PMID: 28277149 DOI: 10.1080/01913123.2016.1275909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Castanea sativa Mill (ENC®), containing tannins against 33 Chlamydia strains, was compared to SMAP-29 with inhibitory effect against C. trachomatis and C. pneumoniae. The ENC® activity against Chlamydia spp. was evaluated determining the lowest concentration to achieve more than half reduction of intact chlamydial inclusions versus controls. ENC® reduced all Chlamydia strains tested at 1 µg/mL, while SMAP-29 induced reductions of C. trachomatis and C. pneumoniae infectivity at 10 µg/mL. A great reduction of C. trachomatis, C. pneumoniae, and C. abortus infectivity was achieved with a 10 µg/mL ENC® concentration, whereas their infectivity was almost inhibited at 100 µg/mL ENC® concentration.
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Affiliation(s)
- Valentina Papa
- a Biomedical and Neuromotor Sciences Department, Pathology , University of Bologna , Bologna , Italy
| | - Laura Ginocchietti
- b Experimental Diagnostic and Specialty Medicine Department, Microbiology , University of Bologna , Bologna , Italy
| | - Roberta Budriesi
- c Pharmacy and Biotechnology Department , University of Bologna , Bologna , Italy
| | - Matteo Micucci
- c Pharmacy and Biotechnology Department , University of Bologna , Bologna , Italy
| | - Roberta Costa
- a Biomedical and Neuromotor Sciences Department, Pathology , University of Bologna , Bologna , Italy
| | - Roberta Biondi
- b Experimental Diagnostic and Specialty Medicine Department, Microbiology , University of Bologna , Bologna , Italy
| | - Roberto Cevenini
- b Experimental Diagnostic and Specialty Medicine Department, Microbiology , University of Bologna , Bologna , Italy
| | - Alberto Chiarini
- b Experimental Diagnostic and Specialty Medicine Department, Microbiology , University of Bologna , Bologna , Italy
| | - Rita Aldini
- c Pharmacy and Biotechnology Department , University of Bologna , Bologna , Italy
| | - Manuela Donati
- b Experimental Diagnostic and Specialty Medicine Department, Microbiology , University of Bologna , Bologna , Italy
| | - Gian Matteo Pollini
- b Experimental Diagnostic and Specialty Medicine Department, Microbiology , University of Bologna , Bologna , Italy
| | - Giovanna Cenacchi
- a Biomedical and Neuromotor Sciences Department, Pathology , University of Bologna , Bologna , Italy
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Zhanel GG, Fontaine S, Adam H, Schurek K, Mayer M, Noreddin AM, Gin AS, Rubinstein E, Hoban DJ. A Review of New Fluoroquinolones : Focus on their Use in Respiratory Tract Infections. ACTA ACUST UNITED AC 2016; 5:437-65. [PMID: 17154673 DOI: 10.2165/00151829-200605060-00009] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The new respiratory fluoroquinolones (gatifloxacin, gemifloxacin, levofloxacin, moxifloxacin, and on the horizon, garenoxacin) offer many improved qualities over older agents such as ciprofloxacin. These include retaining excellent activity against Gram-negative bacilli, with improved Gram-positive activity (including Streptococcus pneumoniae and Staphylococcus aureus). In addition, gatifloxacin, moxifloxacin and garenoxacin all demonstrate increased anaerobic activity (including activity against Bacteroides fragilis). The new fluoroquinolones possess greater bioavailability and longer serum half-lives compared with ciprofloxacin. The new fluoroquinolones allow for once-daily administration, which may improve patient adherence. The high bioavailability allows for rapid step down from intravenous administration to oral therapy, minimizing unnecessary hospitalization, which may decrease costs and improve quality of life of patients. Clinical trials involving the treatment of community-acquired respiratory infections (acute exacerbations of chronic bronchitis, acute sinusitis, and community-acquired pneumonia) demonstrate high bacterial eradication rates and clinical cure rates. In the treatment of community-acquired respiratory tract infections, the various new fluoroquinolones appear to be comparable to each other, but may be more effective than macrolide or cephalosporin-based regimens. However, additional data are required before it can be emphatically stated that the new fluoroquinolones as a class are responsible for better outcomes than comparators in community-acquired respiratory infections. Gemifloxacin (except for higher rates of hypersensitivity), levofloxacin, and moxifloxacin have relatively mild adverse effects that are more or less comparable to ciprofloxacin. In our opinion, gatifloxacin should not be used, due to glucose alterations which may be serious. Although all new fluoroquinolones react with metal ion-containing drugs (antacids), other drug interactions are relatively mild compared with ciprofloxacin. The new fluoroquinolones gatifloxacin, gemifloxacin, levofloxacin, and moxifloxacin have much to offer in terms of bacterial eradication, including activity against resistant respiratory pathogens such as penicillin-resistant, macrolide-resistant, and multidrug-resistant S. pneumoniae. However, ciprofloxacin-resistant organisms, including ciprofloxacin-resistant S. pneumoniae, are becoming more prevalent, thus prudent use must be exercised when prescribing these valuable agents.
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Affiliation(s)
- George G Zhanel
- Department of Medical Microbiology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Clinical Microbiology, Health Sciences Centre, Winnipeg, Manitoba, CanadaDepartment of Medicine, Health Sciences Centre, Winnipeg, Manitoba, Canada
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Tetracycline Susceptibility in Chlamydia suis Pig Isolates. PLoS One 2016; 11:e0149914. [PMID: 26913523 PMCID: PMC4767523 DOI: 10.1371/journal.pone.0149914] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 02/06/2016] [Indexed: 11/26/2022] Open
Abstract
The aims of the present study were to assess the prevalence of Chlamydia suis in an Italian pig herd, determine the tetracycline susceptibility of C. suis isolates, and evaluate tet(C) and tetR(C) gene expression. Conjunctival swabs from 20 pigs were tested for C. suis by real-time polymerase chain reaction, and 55% (11) were positive. C. suis was then isolated from 11 conjunctival swabs resampled from the same herd. All positive samples and isolates were positive for the tet(C) resistance gene. The in vitro susceptibility to tetracycline of the C. suis isolates showed MIC values ranging from 0.5 to 4 μg/mL. Tet(C) and tetR(C) transcripts were found in all the isolates, cultured both in the absence and presence of tetracycline. This contrasts with other Gram-negative bacteria in which both genes are repressed in the absence of the drug. Further investigation into tet gene regulation in C. suis is needed.
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Abstract
We investigated the Chlamydia spp. occurrence in Eurasian Collared Doves (Streptopelia decaocto) from urban and suburban areas in northern Italy. Among 76 doves screened, prevalence of Chlamydia spp. was 61%. Chlamydia psittaci genotype E was identified in 33 of the 46 positive samples. The multilocus sequence typing pattern of one highly positive sample showed a new allelic combination. The same molecular features were observed in a C. psittaci strain subsequently isolated from a live dove. Our results reveal a high C. psittaci prevalence in S. decaocto. The spread of this zoonotic pathogen from collared doves to other birds or humans seems to be a potential risk.
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Chlamydia abortus: New Aspects of Infectious Abortion in Sheep and Potential Risk for Pregnant Women. CURRENT CLINICAL MICROBIOLOGY REPORTS 2015. [DOI: 10.1007/s40588-015-0014-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Castro Robles LJ, Sahagún Prieto AM, Diez Liébana MJ, Fernández Martínez N, Sierra Vega M, García Vieitez JJ. Pharmacokinetic behavior of doxycycline after intramuscular injection in sheep. Am J Vet Res 2012; 73:714-8. [PMID: 22533405 DOI: 10.2460/ajvr.73.5.714] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the pharmacokinetics of a commercial formulation of doxycycline hyclate after IM administration of a single dose to sheep. ANIMALS 11 healthy domestic sheep. PROCEDURES For each sheep, doxycycline was administered as a single dose of 20 mg/kg, IM. Blood samples were obtained prior to and for 84 hours after doxycycline administration. Plasma concentrations of doxycycline were determined via high-performance liquid chromatography with UV detection. Pharmacokinetic data were analyzed with noncompartmental methods. RESULTS Mean ± SD values for pharmacokinetic parameters included maximum plasma concentration (2.792 ± 0.791 μg/mL), time to reach maximum plasma concentration (0.856 ± 0.472 hours), mean residence time (91.1 ± 40.78 hours), elimination half-life (77.88 ± 28.45 hours), and area under the curve (65.67 ± 9.877 μg•h/mL). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that doxycycline had prolonged absorption and elimination in sheep after IM administration. A daily dose of 20 mg/kg would be sufficient to reach effective plasma concentrations against Chlamydia spp (minimum inhibitory concentration, 0.008 to 0.031 μg/mL) and Staphylococcus aureus (minimum inhibitory concentration, 0.12 μg/mL). Doxycycline administered IM could be an option for therapeutic use in sheep, although further studies are needed.
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Affiliation(s)
- Luis J Castro Robles
- Department of Biomedical Sciences, Institute of Biomedicine, Veterinary Faculty, University of Leon, León, Spain
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In vitro antichlamydial activity of garenoxacin against Chlamydia trachomatis. J Infect Chemother 2011; 18:428-35. [PMID: 22113367 DOI: 10.1007/s10156-011-0345-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 11/01/2011] [Indexed: 10/15/2022]
Abstract
Garenoxacin showed the most potent chlamydial activity against Chlamydia trachomatis D/UW-3/Cx among three tested quinolones and azithromycin. The DNA gyrase genes, gyrA and gyrB, of C. trachomatis D/UW-3/Cx were cloned and the GyrA and GyrB subunits of DNA gyrase protein were separately expressed as histidine-tagged proteins in Escherichia coli. The mean 50% inhibitory concentration (IC(50)) of garenoxacin against the supercoiling activity of C. trachomatis D/UW-3/Cx gyrase was 2.9 ± 0.4 μg/ml, which was the most potent inhibitory activity against DNA gyrase among the quinolones tested in this study. At an extracellular concentration of 0.5 μg/ml, the cellular-to-extracellular concentration ratio of garenoxacin was 15.3 ± 1.3, equivalent to that of moxifloxacin and greater than that of levofloxacin. In a time-kill experiment, after exposure to garenoxacin at a concentration of 0.5 μg/ml at 0-6, 5-11, and 24-30 h after infection, the percentages of recoverable chlamydial inclusion-forming units were 11.1 ± 3.3, 0.6 ± 0.1, and 2.6 ± 0.5%, respectively. On transmission electron microscopy observation, after exposure to garenoxacin at 24-30 h after infection, some C. trachomatis elementary bodies remained in the inclusion body; however, the reticulate bodies were completely disrupted. In conclusion, garenoxacin is expected to be a useful quinolone in the treatment of infectious diseases caused by C. trachomatis.
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Donati M, Di Francesco A, Gennaro R, Benincasa M, Di Paolo M, Shurdhi A, Ostanello F, Baldelli R, Cevenini R. Increasing effect of a high dose of PG-1 peptide on the infectivity ofChlamydophila abortus. ACTA ACUST UNITED AC 2010; 59:221-2. [DOI: 10.1111/j.1574-695x.2010.00679.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
We set up a polarized cell culture model to study the pathogenicity of a common respiratory tract pathogen, Chlamydia pneumoniae. Immunofluorescence staining of ZO-1 (a tight junction protein) and Na(+)K(+) ATPase (a protein pump localized at the basolateral membrane in the polarized epithelial cells), as well as TER measurements, suggested that the filter-grown Calu-3 cells, but not the A549 cells, were polarized when grown on collagen-coated membranes. Both the flat and the filter-grown cultures were infected with C. pneumoniae. Infection in the polarized Calu-3 cultures produced more C. pneumoniae genome equivalents than infection in the flat cultures. However, this progeny was not as infective as that in the flat cultures. The maximum amount of C. pneumoniae was detected at 6 days postinfection in the filter-grown A549 cells, indicating a slower developmental cycle than that observed in the flat A549 cultures. The effect of cycloheximide on the growth of C. pneumoniae in the polarized cells was negligible. Furthermore, the infection in the polarized Calu-3 cells was resistant to doxycycline, and several cytokines were released mainly on the apical side of the polarized cells in response to C. pneumoniae infection. These findings indicate that the growth of chlamydiae was altered in the filter-grown epithelial culture system. The diminished production of infective progeny of C. pneumoniae, together with the resistance to doxycycline and polarized secretion of cytokines from the infected Calu-3 cells, suggests that this model is useful for examining epithelial cell responses to C. pneumoniae infection, and it might better resemble in vivo infection in respiratory epithelial cells.
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Petrovay F, Balla E. Two fatal cases of psittacosis caused by Chlamydophila psittaci. J Med Microbiol 2008; 57:1296-1298. [PMID: 18809562 DOI: 10.1099/jmm.0.2008/001578-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Two fatal cases of psittacosis are described in two poultry-processing-plant employees presenting with pneumonia and respiratory failure. Diagnosis was confirmed by serological and PCR methods. Psittacosis due to Chlamydophila psittaci infection usually has a good recovery rate, although diagnostic delay and mistreatment can lead to severe complications and even death. This report emphasizes the need for rapid differential diagnosis and management of suspected cases of atypical pneumonia to prevent fatal outcomes.
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Affiliation(s)
- Fruzsina Petrovay
- Department of Bacteriology, National Centre for Epidemiology, Gyáli út 2-6, Budapest 1097, Hungary
| | - Eszter Balla
- Department of Bacteriology, National Centre for Epidemiology, Gyáli út 2-6, Budapest 1097, Hungary
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Di Francesco A, Donati M, Rossi M, Pignanelli S, Shurdhi A, Baldelli R, Cevenini R. Tetracycline-resistant Chlamydia suis isolates in Italy. Vet Rec 2008; 163:251-2. [PMID: 18723867 DOI: 10.1136/vr.163.8.251] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- A Di Francesco
- Department of Veterinary Public Health and Animal Pathology, Faculty of Veterinary Medicine, University of Bologna, Bologna, Italy
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Hisada H, Yamazaki T, Inoue M, Sato K, Ando S, Kishimoto T. In vitro activity of garenoxacin against Chlamydia spp. J Chemother 2008; 20:282-4. [PMID: 18467258 DOI: 10.1179/joc.2008.20.2.282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- H Hisada
- Research Laboratories, Toyama Chemical Co., Ltd., Toyama, Japan.
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Krishna G, Kisicki JC, Olsen S, Grasela DM, Wang Z. The Effect of Omeprazole on the Bioavailability and Safety of Garenoxacin in Healthy Volunteers. J Clin Pharmacol 2007; 47:628-32. [PMID: 17395892 DOI: 10.1177/0091270006299136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The effect of coadministration of omeprazole on the bioavailability of oral garenoxacin was evaluated in an open-label study in 14 healthy subjects. Single-dose pharmacokinetics of garenoxacin were determined with and without steady-state omeprazole. Following an oral dose of garenoxacin 600 mg on day 1, serial blood samples were obtained over the next 72 hours. Omeprazole 40 mg once daily was administered from days 4 to 10. A second pharmacokinetic assessment of garenoxacin was conducted on day 8. Geometric means for the maximum observed concentration and area under the concentration-time curve from time 0 extrapolated to infinity were 9.6 microg/mL (18.2%) and 132.0 microg.h/mL (18.9%), respectively, for garenoxacin alone and 9.3 microg/mL (21.6%) and 140.4 microg.h/mL (22.1%), respectively, for coadministered garenoxacin and omeprazole. The 90% confidence interval for the ratio of geometric means (with/without omeprazole) for both variables was contained within 0.80 to 1.25, and the bioavailability of garenoxacin was not affected by the concomitant administration of omeprazole.
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Affiliation(s)
- Gopal Krishna
- Schering-Plough Research Institute, 2015 Galloping Hill Road, Kenilworth, NJ 07033, USA.
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Jones RN, Sader HS, Stilwell MG, Fritsche TR. Garenoxacin activity against isolates form patients hospitalized with community-acquired pneumonia and multidrug-resistant Streptococcus pneumoniae. Diagn Microbiol Infect Dis 2007; 58:1-7. [PMID: 17408904 DOI: 10.1016/j.diagmicrobio.2007.01.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Accepted: 01/27/2007] [Indexed: 11/18/2022]
Abstract
Community-acquired pneumonia (CAP) continues to cause significant morbidity worldwide, and the principal bacterial pathogens (Streptococcus pneumoniae and Haemophilus influenzae) have acquired numerous resistance mechanisms over the last few decades. CAP treatment guidelines have suggested the use of broader spectrum agents, such as antipneumococcal fluoroquinolones as the therapy for at-risk patient population. In this report, we studied 3087 CAP isolates from the SENTRY Antimicrobial Surveillance Program (1999-2005) worldwide and all respiratory tract infection (RTI) isolate population of pneumococci (14665 strains) grouped by antibiogram patterns against a new des-F(6)-quinolone, garenoxacin. Results indicated that garenoxacin was highly active against CAP isolates of S. pneumoniae (MIC(90), 0.06 microg/mL) and H. influenzae (MIC(90), < or =0.03 microg/mL). This garenoxacin potency was 8- to 32-fold greater than gatifloxacin, levofloxacin, and ciprofloxacin against the pneumococci and >99.9% of strains were inhibited at < or =1 microg/mL (proposed susceptible breakpoint). Garenoxacin MIC values were not affected by resistances among S. pneumoniae strains to penicillin or erythromycin; however, coresistances were high among the beta-lactams (penicillins and cephalosporins), macrolides, tetracyclines, and trimethoprim/sulfamethoxazole. Analysis of S. pneumoniae isolates with various antimicrobial resistance patterns to 6 drug classes demonstrated that garenoxacin was active against >99.9% (MIC, < or =1 microg/mL) of strains, and the most resistant pneumococci (6-drug resistance, 1051 strains or 7.2% of all isolates) were completely susceptible (100.0% at < or =1 microg/mL) to garenoxacin (MIC(90), 0.06 microg/mL). These results illustrate the high activity of garenoxacin against contemporary CAP isolates and especially against multidrug-resistant (MDR) S. pneumoniae that have created therapeutic dilemmas for all RTI presentations. Garenoxacin appears to be a welcome addition to the CAP treatment options, particularly for the emerging MDR pneumococci strains.
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Sader HS, Fritsche TR, Jones RN. In vitro activity of garenoxacin tested against a worldwide collection of ciprofloxacin-susceptible and ciprofloxacin-resistant Enterobacteriaceae strains (1999-2004). Diagn Microbiol Infect Dis 2007; 58:27-32. [PMID: 17383140 DOI: 10.1016/j.diagmicrobio.2006.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Accepted: 12/07/2006] [Indexed: 11/15/2022]
Abstract
Garenoxacin is a novel des-F(6)-quinolone with a chemical structure that lacks the C6 position fluorine and has a unique difluoromethoxy substitution at position C8. This study evaluated the in vitro activity of garenoxacin tested against a large collection of Enterobacteriaceae collected worldwide. The bacterial isolates were consecutively collected from more than 70 medical centers from bloodstream, respiratory, urinary tract, and skin and soft tissue infections. The isolates were tested against garenoxacin, ciprofloxacin, levofloxacin, gatifloxacin, moxifloxacin, and many other oral and parenteral antimicrobial agents. All isolates were susceptibility tested by broth microdilution methods according to the Clinical and Laboratory Standards Institute (CLSI) guidelines and interpretative criteria. A garenoxacin-susceptible breakpoint of < or =2 microg/mL was applied for comparison purposes only. The fluoroquinolones were the most active oral compounds with overall susceptibility rates of 87.5% to 90.0%. Garenoxacin showed in vitro activity comparable with that of ciprofloxacin and the other fluoroquinolones against Escherichia coli (MIC(50), < or =0.03 microg/mL; 87.3% susceptible), Klebsiella spp. (MIC(50), 0.12 microg/mL; 90.4-94.5% susceptible), Enterobacter spp. (MIC(50), 0.12 microg/mL; 85.6-86.5% susceptible), Salmonella spp. (MIC(50), 0.06 microg/mL; 99.7% susceptible), and Shigella spp. (MIC(50), < or =0.03 microg/mL; 99.9% susceptible), which accounted for 87.0% of the Enterobacteriaceae strains tested. Garenoxacin was highly active against ciprofloxacin-susceptible strains (98.1% susceptibility), whereas ciprofloxacin-resistant strains were generally resistant to all other fluoroquinolones and also showed high rates of resistance to other orally administered antimicrobials. In conclusion, garenoxacin in vitro activity was similar to that of currently marketed fluoroquinolones and superior to other orally administered antimicrobial agents (cephalosporins, amoxicillin/clavulanate, and trimethoprim/sulfamethoxazole) when tested against more than 45,000 globally collected Enterobacteriaceae.
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Fritsche TR, Sader HS, Jones RN. Potency and spectrum of garenoxacin tested against an international collection of skin and soft tissue infection pathogens: report from the SENTRY antimicrobial surveillance program (1999-2004). Diagn Microbiol Infect Dis 2007; 58:19-26. [PMID: 17383139 DOI: 10.1016/j.diagmicrobio.2006.12.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2006] [Accepted: 12/08/2006] [Indexed: 01/22/2023]
Abstract
The spectrum and potency of garenoxacin, a novel des-F(6)-quinolone, against a large international collection (11723 strains) of Gram-positive and Gram-negative bacterial pathogens that cause skin and soft tissue infections (SSTIs) were evaluated for the years 1999 to 2004. Consecutive nonduplicate bacterial isolates were collected from patients with documented community-acquired or nosocomial SSTI in >70 medical centers participating in the SENTRY Antimicrobial Surveillance Program in North America (37.4%), Europe (26.7%), Latin America (16.7%), and the Asia-Pacific region (19.2%). All isolates were tested using the reference broth microdilution methods against garenoxacin, ciprofloxacin, levofloxacin, gatifloxacin, moxifloxacin, and representative comparator agents used for the empiric or directed therapy for SSTI. Ranking pathogens producing SSTI during these years included Staphylococcus aureus (42.8%), Pseudomonas aeruginosa (11.1%), Escherichia coli (9.0%), Enterococcus spp. (7.3%), Klebsiella spp. (4.8%), Enterobacter spp. (4.7%), beta-hemolytic streptococci (4.3%), coagulase-negative staphylococci (4.0%), Proteus mirabilis (2.5%), and Acinetobacter spp. (2.1%). Garenoxacin was the most potent agent tested against S. aureus and was at least 2-fold more active than gatifloxacin (MIC(50), 0.06 mg/L) and 8-fold more active than levofloxacin (MIC(50), 0.25 mg/L). Furthermore, garenoxacin was 2- to 8-fold more potent than the fluoroquinolones against beta-hemolytic and viridans group streptococci, as well as up to 4-fold more active against enterococci. Garenoxacin was largely comparable with the comparator fluoroquinolones against E. coli, Klebsiella spp., and Acinetobacter spp., but it is less active than these agents against P. aeruginosa. In summary, garenoxacin was documented to be the most potent quinolone when tested against key Gram-positive pathogens (S. aureus, beta-hemolytic streptococci, viridans group streptococci, and enterococci) and was similar in activity to these agents against other species (Enterobacteriaceae and Acinetobacter spp.). These in vitro data suggest that garenoxacin warrants further clinical studies in SSTI, especially against staphylococci and streptococcal pathogens.
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21
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Walder G, Hotzel H, Brezinka C, Gritsch W, Tauber R, Würzner R, Ploner F. An unusual cause of sepsis during pregnancy: recognizing infection with chlamydophila abortus. Obstet Gynecol 2006; 106:1215-7. [PMID: 16260577 DOI: 10.1097/01.aog.0000161060.69470.9c] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chlamydophila abortus (formerly Chlamydia psittaci serovar 1) is a rare but severe cause of gestational septicemia, with particular problems in diagnosis and clinical management. CASE A 32-year-old woman in her fourth pregnancy (16th week of gestation) presented with progressive septicemia after extensive contact with abortive material from her goat flock. Treatment with levofloxacin could not prevent abortion. Multiorgan failure requiring catecholamines and artificial ventilation developed in the patient. After the agent was identified by polymerase chain reaction from acute-phase serum, macrolides were administered and yielded clinical improvement. The patient fully recovered. There were no sequelae in the subsequent 6 months. CONCLUSION Cp abortus must be considered in gestational septicemia after contact with ruminants. Polymerase chain reaction from acute-phase serum is a quick and easy way to establish the diagnosis. Macrolide antibiotics are still the treatment of choice.
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Affiliation(s)
- Gernot Walder
- Department of Hygiene and Social Medicine, Medical University of Innsbruck, Innsbruck, Austria, and Department of Anesthesiology, Regional Hospital of Sterzing, Sterzing, Italy.
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22
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Smelov V, Perekalina T, Artemenko N, Smelova N, Ukleeva G, Gorelov A. Chlamydia trachomatis survival in the presence of two fluoroquinolones (lomefloxacin versus levofloxacin) in patients with chronic prostatitis syndrome. Andrologia 2005; 37:61-4. [PMID: 16026425 DOI: 10.1111/j.1439-0272.2005.00654.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Fluoroquinolones are recommended in the therapy of chronic prostatitis. Chlamydia trachomatis is one of the possible aetiological agents of chronic prostatitis. However, little is known about chlamydia survival in the presence of fluoroquinolones in patients with chronic prostatitis syndrome. For the first time, chlamydia survival in vitro in the presence of lomefloxacin (LOMX) (mostly recommended in the treatment of chronic prostatitis) versus levofloxacin (LVFX) (recommended in the therapy against chlamydia infection) is examined and analysed in the 33 chlamydia-infected patients with chronic prostatitis syndrome in this study. Antichlamydial activity in vitro of LOMX in patients with C. trachomatis and prostatitis was found to be more effective than LVFX. However, further clinical trials for these agents are recommended.
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Affiliation(s)
- V Smelov
- Medical Department, St Petersburg State University, St. Petersburg, Russia.
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23
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Donati M, Di Leo K, Benincasa M, Cavrini F, Accardo S, Moroni A, Gennaro R, Cevenini R. Activity of cathelicidin peptides against Chlamydia spp. Antimicrob Agents Chemother 2005; 49:1201-2. [PMID: 15728927 PMCID: PMC549261 DOI: 10.1128/aac.49.3.1201-1202.2005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The in vitro activity of six cathelicidin peptides against 25 strains of Chlamydia was investigated. SMAP-29 proved to be the most active peptide, reducing the inclusion numbers of all 10 strains of Chlamydia trachomatis tested by > or =50% at 10 microg/ml. This peptide was also active against C. pneumoniae and C. felis.
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Affiliation(s)
- Manuela Donati
- Sezione di Microbiologia, DMCSS, Policlinico S.Orsola, Università di Bologna, Via Massarenti 9, 40138 Bologna, Italy
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24
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Hammerschlag MR. Advances in the management of Chlamydia pneumoniae infections. Expert Rev Anti Infect Ther 2004; 1:493-503. [PMID: 15482145 DOI: 10.1586/14787210.1.3.493] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
One of the major characteristics of Chlamydia spp. is its ability to cause prolonged, often subclinical infections. Chronic, persistent infection with Chlamydia pneumoniae has been implicated in the pathogenesis of several chronic diseases initially not thought to be infectious, including asthma, arthritis and atherosclerosis. C. pneumoniae is susceptible in vitro to a wide range of antimicrobial agents that target either protein or DNA synthesis, including macrolides, ketolides, tetracyclines, quinolones and rifamycins. Practically all treatment studies evaluating presented or published to date have used serology alone for diagnosis of C. pneumoniae infection, which only provides a clinical end point. The results of several treatment studies that did perform culture found that erythromycin, azithromycin (Zithromax, clarithromycin (Biaxin, levofloxacin (Levaquin and moxifloxacin (Avelox had a 70 to 90% efficacy in eradicating C. pneumoniae from the respiratory tract of children and adults with pneumonia. Persistence of the organism does not appear to be due to the development of antibiotic resistance. However, one cannot extrapolate from this experience to the treatment of chronic C. pneumoniae infection, especially cardiovascular disease. As there are no reliable serologic markers for chronic or persistent C. pneumoniae infection, it cannot be determined who is infected and who is not, which means that it cannot be assumed that any effect seen is due to successful treatment or eradication of C. pneumoniae.
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Affiliation(s)
- Margaret R Hammerschlag
- Division of Pediatric Infectious Diseases, SUNY Downstate Medical Center, Brooklyn, NY 11203-2098, USA.
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25
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Smelov V, Perekalina T, Gorelov A, Smelova N, Artemenko N, Norman L. In Vitro Activity of Fluoroquinolones, Azithromycin and Doxycycline against Chlamydia Trachomatis Cultured from Men with Chronic Lower Urinary Tract Symptoms. Eur Urol 2004; 46:647-50. [PMID: 15474277 DOI: 10.1016/j.eururo.2004.06.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2004] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Little is known about chlamydia survival in the presence of fluoroquinolones in patients with chronic prostatitis syndrome (CPS). In vitro activities of four fluoroquinolones, azithromycin and doxycycline against C. trachomatis in patients with CPS being not treated with antibiotics earlier were investigated and compared. MATERIAL AND METHODS Chlamydia survival in 304 patients with CPS being not treated with antibiotics earlier was analysed and compared. Infection by C. trachomatis was determined in the urethra and expressed prostatic secretion by cell culture test. RESULTS Azithromycin and ofloxacin were found to be the most active antichlamydial agent with ciprofloxacin and doxycycline being least active. CONCLUSION Ofloxacin can be recommended as the primary drug in the treatment of chlamydia-infected patients with CPS. The decision on the prescription of other fluoroquinolones should be made individually. The investigation of chlamydia survival in the presence of antibiotics in patients with CPS and C. trachomatis prior to treatment is recommended.
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Affiliation(s)
- V Smelov
- Medical Department, St. Petersburg State University, St. Petersburg, Russia.
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26
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Smith RP, Baltch AL, Ritz WJ, Carpenter AN, Halse TA, Bopp LH. In vitro activities of garenoxacin and levofloxacin against Chlamydia pneumoniae are not affected by presence of Mycoplasma DNA. Antimicrob Agents Chemother 2004; 48:2081-4. [PMID: 15155203 PMCID: PMC415625 DOI: 10.1128/aac.48.6.2081-2084.2004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We studied 20 Chlamydia pneumoniae isolates obtained from respiratory sites and atheroma tissue of patients from various geographic areas to determine the susceptibilities of these isolates to a new des-fluoroquinolone, garenoxacin, and to levofloxacin. In addition, we assessed the cultures with these isolates by PCR for the presence or absence of Mycoplasma sp. DNA. Both the MIC at which 90% of isolates are inhibited (MIC(90)) and the minimal bactericidal concentration at which 90% of isolates are killed (MBC(90)) for garenoxacin were 0.06 microg/ml, and both the MIC(90) and the MBC(90) for levofloxacin were 2.0 microg/ml. The activity of garenoxacin against C. pneumoniae was 32-fold greater than that of levofloxacin. Mycoplasma sp. DNA was detected by PCR in 17 of 20 cultures. Mycoplasma amplicons from five Mycoplasma DNA-positive C. pneumoniae cultures were sequenced and found to represent four Mycoplasma species. Our data demonstrate that C. pneumoniae cultures frequently contain Mycoplasma DNA and that its presence in C. pneumoniae cultures does not appear to affect the susceptibility results for the two fluoroquinolones that we tested.
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Affiliation(s)
- Raymond P Smith
- Stratton Veterans Affairs Medical Center, New York State Department of Health, Albany, NY 12208, USA
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27
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Di Francesco A, Donati M, Carelle MS, Cevenini R, Baldelli R. Molecular characterisation of a Chlamydophila felis isolate from a cat in Italy. Vet Rec 2004; 154:239-40. [PMID: 15005450 DOI: 10.1136/vr.154.8.239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- A Di Francesco
- Department of Veterinary Public Health and Animal Pathology, Alma Mater Studiorum University di Bologna, via Tolara di Sopra 50, 40064 Ozzano Emilia (BO), Italy
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28
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Ameyama S, Shinmura Y, Takahata M. Inhibitory activities of quinolones against DNA gyrase of Chlamydia pneumoniae. Antimicrob Agents Chemother 2003; 47:2327-9. [PMID: 12821490 PMCID: PMC161870 DOI: 10.1128/aac.47.7.2327-2329.2003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The gyrA and gyrB genes of Chlamydia pneumoniae TW-183 were cloned, and their proteins were purified by use of a fusion system with a maltose-binding protein. The 50% inhibitory concentrations of garenoxacin, sparfloxacin, moxifloxacin, gatifloxacin, and levofloxacin were 10.1, 47.5, 39.6, 64.2, and 156.9 microg/ml, respectively, and the MICs against C. pneumoniae TW-183 were 0.008, 0.016, 0.063, 0.125, and 0.25 microg/ml, respectively.
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Affiliation(s)
- Satoshi Ameyama
- Research Laboratories, Toyama Chemical Co, Ltd, Toyama 930-8508, Japan.
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29
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Roblin PM, Reznik T, Hammerschlag MR. In vitro activity of garenoxacin against recent clinical isolates of Chlamydia pneumoniae. Int J Antimicrob Agents 2003; 21:578-80. [PMID: 12791473 DOI: 10.1016/s0924-8579(03)00061-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The in vitro activities of garenoxacin, a novel des-F (6)-quinolone, levofloxacin, moxifloxacin and clarithromycin were tested against 30 recent clinical isolates of Chlamydia pneumoniae. The minimal inhibitory concentration (MIC) at which 90% of the isolates were inhibited and the minimal bactericidal concentration (MBC) at which 90% of the isolates were killed by garenoxacin for C. pneumoniae was 0.03 mg/l (range 0.015-0.03 mg/l).
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Affiliation(s)
- Patricia M Roblin
- Division of Infectious Diseases, Department of Pediatrics, State University of New York Downstate Medical Center, Box 49, 450 Clarkson Avenue, Brooklyn, NY 11203-2098, USA
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30
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Mair M. Publications of Interest. Biosecur Bioterror 2003. [DOI: 10.1089/15387130360514869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Michael Mair
- Center for Civilian Biodefense Strategies, Johns Hopkins University
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