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Sharma N, Chhillar AK, Dahiya S, Punia A, Choudhary P, Gulia P, Behl A, Dangi M. Chemotherapeutic Strategies for Combating Staphylococcus aureus Infections. Mini Rev Med Chem 2021; 22:26-42. [PMID: 33797362 DOI: 10.2174/1389557521666210402150325] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/08/2021] [Accepted: 03/09/2021] [Indexed: 11/22/2022]
Abstract
Staphylococcus aureus is a prominent human pathogen that causes nosocomial and community acquired infections. The accelerating emergence and prevalence of staphylococcal infections have grotesque health consequences which are mostly due to its anomalous capability to acquire drug resistance and scarcity of novel classes of antibacterials. Many combating therapies are centered on primary targets of S. aureus which are cell envelope, ribosomes and nucleic acids. This review describes various chemotherapeutic strategies for combating S. aureus infections which includes monotherapy, combination drug therapy, phage endolysin therapy, lysostaphins and antibacterial drones. Monotherapy has dwindled in due course of time but combination therapy, endolysin therapy, lysostaphin and antibacterial drones are emerging alternatives which efficiently conquer the shortcomings of monotherapy. Combinations of more than one antibiotic agents or combination of adjuvant with antibiotics provide a synergistic approach to combat infections causing pathogenic strains. Phage endolysin therapy and lysostaphin are also presents as possible alternatives to conventional antibiotic therapies. Antibacterial Drones goes a step further by specifically targeting the virulence genes in bacteria giving them a certain advantage over existing antibacterial strategies. But the challenge remains on the better understanding of these strategies for executing and implementing them in health sector. In this day and age, most of the S. aureus strains are resistant to ample number of antibiotics, so there is an urgent need to overcome such multidrug resistant strains for the welfare of our community.
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Affiliation(s)
| | | | | | - Aruna Punia
- Centre for Biotechnology, MDU, Rohtak 124001. India
| | | | - Prity Gulia
- Centre for Biotechnology, MDU, Rohtak 124001. India
| | | | - Mehak Dangi
- Centre for Bioinformatics, MDU, Rohtak 124001. India
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Dinarvand M, Spain MP, Vafaee F. Pharmacodynamic Functions of Synthetic Derivatives for Treatment of Methicillin-Resistant Staphylococcus aureus (MRSA) and Mycobacterium tuberculosis. Front Microbiol 2020; 11:551189. [PMID: 33329419 PMCID: PMC7729195 DOI: 10.3389/fmicb.2020.551189] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 11/05/2020] [Indexed: 12/26/2022] Open
Abstract
Drug resistant bacteria have emerged, so robust methods are needed to evaluate combined activities of known antibiotics as well as new synthetic compounds as novel antimicrobial agents to treatment efficacy in severe bacterial infections. Marine natural products (MNPs) have become new strong leads in the drug discovery endeavor and an effective alternative to control infections. Herein, we report the bioassay guided fractionation of marine extracts from the sponges Lendenfeldia, Ircinia, and Dysidea that led us to identify novel compounds with antimicrobial properties. Chemical synthesis of predicted compounds and their analogs has confirmed that the proposed structures may encode novel chemical structures with promising antimicrobial activity against the medically important pathogens. Several of the synthetic analogs exhibited potent and broad spectrum in vitro antibacterial activity, especially against the Methicillin-resistant Staphylococcus aureus (MRSA) (MICs to 12.5 μM), Mycobacterium tuberculosis (MICs to 0.02 μM), uropathogenic Escherichia coli (MIC o 6.2 μM), and Pseudomonas aeruginosa (MIC to 3.1 μM). Checkerboard assay (CA) and time-kill studies (TKS) experiments analyzed with the a pharmacodynamic model, have potentials for in vitro evaluation of new and existing antimicrobials. In this study, CA and TKS were used to identify the potential benefits of an antibiotic combination (i.e., synthetic compounds, vancomycin, and rifampicin) for the treatment of MRSA and M. tuberculosis infections. CA experiments indicated that the association of compounds 1a and 2a with vancomycin and compound 3 with rifampicin combination have a synergistic effect against a MRSA and M. tuberculosis infections, respectively. Furthermore, the analysis of TKS uncovered bactericidal and time-dependent properties of the synthetic compounds that may be due to variations in hydrophobicity and mechanisms of action of the molecules tested. The results of cross-referencing antimicrobial activity, and toxicity, CA, and Time-Kill experiments establish that these synthetic compounds are promising potential leads, with a favorable therapeutic index for antimicrobial drug development.
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Affiliation(s)
- Mojdeh Dinarvand
- School of Chemistry, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
- Department of Infectious Diseases and Immunology, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South Wales, Sydney, NSW, Australia
| | - Malcolm P. Spain
- School of Chemistry, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Fatemeh Vafaee
- School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South Wales, Sydney, NSW, Australia
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Valderrama MJ, Alfaro M, Rodríguez-Avial I, Baos E, Rodríguez-Avial C, Culebras E. Synergy of Linezolid with Several Antimicrobial Agents against Linezolid-Methicillin-Resistant Staphylococcal Strains. Antibiotics (Basel) 2020; 9:E496. [PMID: 32784878 PMCID: PMC7460281 DOI: 10.3390/antibiotics9080496] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/31/2020] [Accepted: 08/06/2020] [Indexed: 12/22/2022] Open
Abstract
Linezolid is a synthetic oxazolydinone active against multi-resistant Gram-positive cocci that inhibits proteins synthesis by interacting with the 50S ribosomal subunit. Although linezolid-resistant strains are infrequent, several outbreaks have been recently described, associated with prolonged treatment with the antibiotic. As an alternative to monotherapy, the combination of different antibiotics is a commonly used option to prevent the selection of resistant strains. In this work, we evaluated combinations of linezolid with classic and new aminoglycosides (amikacin, gentamicin and plazomicin), carbapenems (doripenem, imipenem and meropenem) and fosfomycin on several linezolid- and methicillin-resistant strains of Staphylococcus aureus and S. epidermidis, isolated in a hospital intensive care unit in Madrid, Spain. Using checkerboard and time-kill assays, interesting synergistic effects were encountered for the combination of linezolid with imipenem in all the staphylococcal strains, and for linezolid-doripenem in S.epidermidis isolates. The combination of plazomicin seemed to also have a good synergistic or partially synergistic activity against most of the isolates. None of the combinations assayed showed an antagonistic effect.
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Affiliation(s)
- María-José Valderrama
- Departamento de Genética, Fisiología y Microbiología, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - María Alfaro
- Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.A.); (I.R.-A.); (E.B.); (E.C.)
| | | | - Elvira Baos
- Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.A.); (I.R.-A.); (E.B.); (E.C.)
| | | | - Esther Culebras
- Hospital Clínico San Carlos, 28040 Madrid, Spain; (M.A.); (I.R.-A.); (E.B.); (E.C.)
- Departamento de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain;
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4
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Lewis PO, Heil EL, Covert KL, Cluck DB. Treatment strategies for persistent methicillin-resistant Staphylococcus aureus bacteraemia. J Clin Pharm Ther 2018; 43:614-625. [PMID: 30003555 DOI: 10.1111/jcpt.12743] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 06/17/2018] [Accepted: 06/22/2018] [Indexed: 01/08/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE Treatment of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia is a long-standing challenge to health care, often complicated by metastatic infections, treatment failure and mortality. When MRSA bacteraemia persists despite adequate initial treatment, current Infectious Diseases Society of America guidelines recommend evaluation and removal of possible sources of infection. In addition, a change in therapy may be considered. The objective of this review was to explore the therapeutic options for the treatment of persistent MRSA bacteraemia. METHODS A literature search of PubMed, MEDLINE and Google Scholar was performed using the following search terms: [methicillin-resistant Staphylococcus aureus OR MRSA] AND [bacteraemia OR bloodstream infection] AND [persistent OR persistence OR refractory OR treatment failure OR salvage] AND treatment. We evaluated relevant, adult, English-language, peer-reviewed studies published between 1985 and May 2018. In vitro and animal studies were considered as supportive of in vivo data. RESULTS AND DISCUSSION Randomized, controlled trials are lacking. However, case series and case reports support multiple treatment options including high-dose daptomycin in combination with an antistaphylococcal β-lactam, ceftaroline, trimethoprim-sulfamethoxazole (TMP-SMX) or fosfomycin; ceftaroline alone or in combination with vancomycin or TMP-SMX; linezolid alone or in combination with a carbapenem, or telavancin. WHAT IS NEW AND CONCLUSION Given the heterogeneity of the data, a preferred regimen has not emerged. Prescribers must take into consideration recent exposure, source control, and available synergy and clinical data. Further comparative trials are needed to establish a preferred regimen and the creation of a universal treatment algorithm.
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Affiliation(s)
- Paul O Lewis
- Department of Pharmacy, Johnson City Medical Center, Johnson City, Tennessee
| | - Emily L Heil
- Department of Pharmacy Practice and Science, School of Pharmacy, University of Maryland, Baltimore, Maryland
| | - Kelly L Covert
- Department of Pharmacy Practice, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee
| | - David B Cluck
- Department of Pharmacy Practice, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee
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Ferrone V, Cotellese R, Carlucci M, Di Marco L, Carlucci G. Air assisted dispersive liquid-liquid microextraction with solidification of the floating organic droplets (AA-DLLME-SFO) and UHPLC-PDA method: Application to antibiotics analysis in human plasma of hospital acquired pneumonia patients. J Pharm Biomed Anal 2018; 151:266-273. [DOI: 10.1016/j.jpba.2017.12.039] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
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Ferrone V, Cotellese R, Di Marco L, Bacchi S, Carlucci M, Cichella A, Raimondi P, Carlucci G. Meropenem, levofloxacin and linezolid in human plasma of critical care patients: A fast semi-automated micro-extraction by packed sorbent UHPLC-PDA method for their simultaneous determination. J Pharm Biomed Anal 2017; 140:266-273. [PMID: 28371721 DOI: 10.1016/j.jpba.2017.03.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 03/15/2017] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
Abstract
An ultra high-performance liquid chromatographic (UHPLC) method with PDA detection was developed and validated for the simultaneous quantification of meropenem, linezolid, and levofloxacin in human plasma and applied in human plasma of critical care patients. A semi-automated microextraction by packed sorbent (MEPS) for sample preparation was used. All parameters in the extraction step (pH, sample volume, sample dilution and number of aspiration - ejection cycles) and in the desorption step (percentage of acetonitrile in the solvent of elution and number of aspirations of elution solvent through the device) were statistically significant when the recovery was used as response. The method showed good linearity with correlation coefficients, r2>0.9991 for the three drugs, as well as high precision (RSD%<10.83% in each case). Accuracy ranged from -7.8% to +6.7%. The limit of quantification of the three drugs was established at 0.01μg/mL for linezolid and levofloxacin and 0.02μg/mL for meropenem. Linezolid, meropenem, levofloxacin and the internal standard were extracted from human plasma with a mean recovery ranged from 92.4% to 97.4%. During validation, the concentration of meropenem, linezolid and levofloxacin was found to be stable after 3 freeze-thaw cycles and for at least 24h after extraction. This method will be subsequently used to quantify the drugs in patients to establish if the dosage regimen given is sufficient to eradicate the infection at the target site.
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Affiliation(s)
- Vincenzo Ferrone
- Dipartimento di Farmacia, Orali e Biotecnologiche - Università degli Studi "G. D'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Roberto Cotellese
- Dipartimento di Scienze Mediche, Orali e Biotecnologiche - Università degli Studi "G. D'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Lorenzo Di Marco
- Dipartimento di Farmacia, Orali e Biotecnologiche - Università degli Studi "G. D'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Simona Bacchi
- Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'Ambiente - Università degli studi di L'Aquila - 671100, L'aquila, Italy
| | - Maura Carlucci
- Dipartimento di Scienze Mediche, Orali e Biotecnologiche - Università degli Studi "G. D'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Annadomenica Cichella
- Dipartimento di Scienze Mediche, Orali e Biotecnologiche - Università degli Studi "G. D'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Paolo Raimondi
- Dipartimento di Scienze Mediche, Orali e Biotecnologiche - Università degli Studi "G. D'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Giuseppe Carlucci
- Dipartimento di Farmacia, Orali e Biotecnologiche - Università degli Studi "G. D'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy.
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Ferrone V, Carlucci M, Cotellese R, Raimondi P, Cichella A, Marco LD, Carlucci G. Development and validation of a fast micro-extraction by packed sorbent UHPLC-PDA method for the simultaneous determination of linezolid and ciprofloxacin in human plasma from patients with hospital-acquired pneumonia. Talanta 2016; 164:64-68. [PMID: 28107984 DOI: 10.1016/j.talanta.2016.11.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 11/07/2016] [Accepted: 11/08/2016] [Indexed: 10/20/2022]
Abstract
An ultra high-performance liquid chromatographic (UHPLC) method with PDA detection was developed and validated for the simultaneous quantification of linezolid and ciprofloxacin in human plasma and applied in hospital acquired pneumonia patients (HAP). The method uses a semi-automated microextraction by packed sorbent for sample preparation. All parameters in the extraction step (pH, sample volume, sample dilution and number of aspiration - ejection cycles) and in the desorption step (percentage of acetonitrile in the solvent of elution and number of aspirations of elution solvent through the device) were statistically significant when the recovery was used as response. The method showed good linearity with correlation coefficients, r2>0.9995 for the two drugs, as well as high precision (RSD%<9.77% in each case), accuracy ranged from -6.2% to +8.2. The limit of quantification of the two drugs was established at 0.01 and 0.02μg/mL for ciprofloxacin and linezolid, respectively. Linezolid, ciprofloxacin and internal standard were extracted from human plasma with a mean recovery ranging from 92.4% to 97.4%. During validation, the concentrations of linezolid and ciprofloxacin were found to be stable after 3 freeze-thaw cycles and for at least 24h after extraction. This method will subsequently be used to quantify the drugs dosage in patients with HAP to establish if the dosage regimen given is sufficient to eradicate the infection at the target site.
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Affiliation(s)
- Vincenzo Ferrone
- Dipartimento di Farmacia, Università degli Studi "G. d'Annunzio" Chieti-Pescara, via dei Vestini, 66100 Chieti, Italy
| | - Maura Carlucci
- Dipartimento di Scienze Mediche Orali e Biotecnologiche, Università degli Studi "G. d'Annunzio" Chieti-Pescara, via dei Vestini, 66100 Chieti, Italy
| | - Roberto Cotellese
- Dipartimento di Scienze Mediche Orali e Biotecnologiche, Università degli Studi "G. d'Annunzio" Chieti-Pescara, via dei Vestini, 66100 Chieti, Italy
| | - Paolo Raimondi
- Dipartimento di Scienze Mediche Orali e Biotecnologiche, Università degli Studi "G. d'Annunzio" Chieti-Pescara, via dei Vestini, 66100 Chieti, Italy
| | - Annadomenica Cichella
- Dipartimento di Scienze Mediche Orali e Biotecnologiche, Università degli Studi "G. d'Annunzio" Chieti-Pescara, via dei Vestini, 66100 Chieti, Italy
| | - Lorenzo Di Marco
- Dipartimento di Farmacia, Università degli Studi "G. d'Annunzio" Chieti-Pescara, via dei Vestini, 66100 Chieti, Italy
| | - Giuseppe Carlucci
- Dipartimento di Farmacia, Università degli Studi "G. d'Annunzio" Chieti-Pescara, via dei Vestini, 66100 Chieti, Italy.
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8
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Zhao M, Lepak AJ, Andes DR. Animal models in the pharmacokinetic/pharmacodynamic evaluation of antimicrobial agents. Bioorg Med Chem 2016; 24:6390-6400. [PMID: 27887963 DOI: 10.1016/j.bmc.2016.11.008] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 11/02/2016] [Accepted: 11/03/2016] [Indexed: 12/28/2022]
Abstract
Animal infection models in the pharmacokinetic/pharmacodynamic (PK/PD) evaluation of antimicrobial therapy serve an important role in preclinical assessments of new antibiotics, dosing optimization for those that are clinically approved, and setting or confirming susceptibility breakpoints. The goal of animal model studies is to mimic the infectious diseases seen in humans to allow for robust PK/PD studies to find the optimal drug exposures that lead to therapeutic success. The PK/PD index and target drug exposures obtained in validated animal infection models are critical components in optimizing dosing regimen design in order to maximize efficacy while minimize the cost and duration of clinical trials. This review outlines the key components in animal infection models which have been used extensively in antibiotic discovery and development including PK/PD analyses.
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Affiliation(s)
- Miao Zhao
- Institute of Antibiotics Hua-shan Hospital, Fudan University & Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, China; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Alexander J Lepak
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - David R Andes
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Medical Microbiology and Immunology, University of Wisconsin, Madison, WI, USA; William S. Middleton Memorial VA Hospital, Madison, WI, USA.
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Sarrafzadeh F, Mirzabiegi Z, Torabi-Nami M. Vancomycin-Resistant Staphylococcus aureus isolates among hospitalized patients; a tertiary medical care center experience from Southern Iran. COGENT MEDICINE 2016. [DOI: 10.1080/2331205x.2016.1163768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Farhad Sarrafzadeh
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Zienab Mirzabiegi
- Students’ Research Committee, Afzalipour Educational Medical Center, Kerman, Iran
| | - Mohammad Torabi-Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
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Fosfomycin plus β-Lactams as Synergistic Bactericidal Combinations for Experimental Endocarditis Due to Methicillin-Resistant and Glycopeptide-Intermediate Staphylococcus aureus. Antimicrob Agents Chemother 2015; 60:478-86. [PMID: 26525803 DOI: 10.1128/aac.02139-15] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 10/28/2015] [Indexed: 02/01/2023] Open
Abstract
The urgent need of effective therapies for methicillin-resistant Staphylococcus aureus (MRSA) infective endocarditis (IE) is a cause of concern. We aimed to ascertain the in vitro and in vivo activity of the older antibiotic fosfomycin combined with different beta-lactams against MRSA and glycopeptide-intermediate-resistant S. aureus (GISA) strains. Time-kill tests with 10 isolates showed that fosfomycin plus imipenem (FOF+IPM) was the most active evaluated combination. In an aortic valve IE model with two strains (MRSA-277H and GISA-ATCC 700788), the following intravenous regimens were compared: fosfomycin (2 g every 8 h [q8h]) plus imipenem (1 g q6h) or ceftriaxone (2 g q12h) (FOF+CRO) and vancomycin at a standard dose (VAN-SD) (1 g q12h) and a high dose (VAN-HD) (1 g q6h). Whereas a significant reduction of MRSA-227H load in the vegetations (veg) was observed with FOF+IPM compared with VAN-SD (0 [interquartile range [IQR], 0 to 1] versus 2 [IQR, 0 to 5.1] log CFU/g veg; P = 0.01), no statistical differences were found with VAN-HD. In addition, FOF+IPM sterilized more vegetations than VAN-SD (11/15 [73%] versus 5/16 [31%]; P = 0.02). The GISA-ATCC 700788 load in the vegetations was significantly lower after FOF+IPM or FOF+CRO treatment than with VAN-SD (2 [IQR, 0 to 2] and 0 [IQR, 0 to 2] versus 6.5 [IQR, 2 to 6.9] log CFU/g veg; P < 0.01). The number of sterilized vegetations after treatment with FOF+CRO was higher than after treatment with VAN-SD or VAN-HD (8/15 [53%] versus 4/20 [20%] or 4/20 [20%]; P = 0.03). To assess the effect of FOF+IPM on penicillin binding protein (PBP) synthesis, molecular studies were performed, with results showing that FOF+IPM treatment significantly decreased PBP1, PBP2 (but not PBP2a), and PBP3 synthesis. These results allow clinicians to consider the use of FOF+IPM or FOF+CRO to treat MRSA or GISA IE.
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Morales-Cartagena A, Lalueza A, López-Medrano F, Juan RS, Aguado JM. Treatment of methicillin-resistant Staphylococcus aureus infections: Importance of high vancomycin minumum inhibitory concentrations. World J Clin Infect Dis 2015; 5:14-29. [DOI: 10.5495/wjcid.v5.i2.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 10/30/2014] [Accepted: 03/09/2015] [Indexed: 02/06/2023] Open
Abstract
Staphylococcus aureus (SA) infections remain a major cause of morbidity and mortality despite the availability of numerous effective anti-staphylococcal antibiotics. This organism is responsible for both nosocomial and community-acquired infections ranging from relatively minor skin and soft tissue infections to life-threatening systemic infections. The increasing incidence of methicillin-resistant strains has granted an increasing use of vancomycin causing a covert progressive increase of its minimum inhibitory concentration (MIC) (dubbed the MIC “creep”). In this way, the emergence of vancomycin-intermediate SA (VISA) strains and heteroresistant-VISA has raised concern for the scarcity of alternative treatment options. Equally alarming, though fortunately less frequent, is the emergence of vancomycin-resistant SA. These strains show different mechanisms of resistance but have similar problems in terms of therapeutic approach. Ultimately, various debate issues have arisen regarding the emergence of SA strains with a minimum inhibitory concentration sitting on the superior limit of the sensitivity range (i.e., MIC = 2 μg/mL). These strains have shown certain resilience to vancomycin and a different clinical behaviour regardless of vancomycin use, both in methicillin-resistant SA and in methicillin-sensitive SA. The aim of this text is to revise the clinical impact and consequences of the emergence of reduced vancomycin susceptibility SA strains, and the different optimal treatment options known.
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Pharmacodynamic and response surface analysis of linezolid or vancomycin combined with meropenem against Staphylococcus aureus. Pharm Res 2015; 32:2410-8. [DOI: 10.1007/s11095-015-1632-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 01/16/2015] [Indexed: 10/24/2022]
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Cabellos C, Garrigós C, Taberner F, Force E, Pachón-Ibañez ME. Experimental study of the efficacy of linezolid alone and in combinations against experimental meningitis due to Staphylococcus aureus strains with decreased susceptibility to beta-lactams and glycopeptides. J Infect Chemother 2014; 20:563-8. [DOI: 10.1016/j.jiac.2014.05.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 05/20/2014] [Accepted: 05/21/2014] [Indexed: 12/01/2022]
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14
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Park HJ, Kim SH, Kim MJ, Lee YM, Park SY, Moon SM, Park KH, Chong YP, Lee SO, Choi SH, Woo JH, Kim YS. Efficacy of linezolid-based salvage therapy compared with glycopeptide-based therapy in patients with persistent methicillin-resistant Staphylococcus aureus bacteremia. J Infect 2012; 65:505-12. [PMID: 22902942 DOI: 10.1016/j.jinf.2012.08.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 07/28/2012] [Accepted: 08/08/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We evaluated the efficacy of linezolid-based salvage therapy compared with glycopeptide-based therapy in patients with persistent (≥7 days) methicillin-resistant Staphylococcus aureus bacteremia (MRSA-B). METHODS All patients with MRSA-B during 2-year period at a tertiary-care hospital were prospectively enrolled. Linezolid-based salvage therapy was classified if patients switched glycopeptides to linezolid with/without carbapenem due to persistent MRSA-B. Covariate adjustment using the propensity score and inverse probability of treatment weighting (IPTW) using the propensity score were performed to control for bias in treatment assignment. RESULTS Of 377 patients with MRSA-B, 90 with persistent MRSA-B were included. Of these, 38 (42%) were classified as linezolid-based salvage group and the remaining 52 (58%) as glycopeptide-based therapy group. The duration of persistent bacteremia (median 16 days vs. 10 days; P = 0.008) was longer in linezolid-based salvage group than in the comparator. However, the 30-day mortality (11% vs. 25%; P = 0.08) had a trend toward being lower in linezolid-based salvage group than those in the comparator. Logistic regression models with covariate adjustment and IPTW using propensity scores also revealed that linezolid-based salvage showed a trend toward having better outcome than the comparator, although this did not reach any statistically significance (OR 0.31; 95% CI 0.03-2.95 and OR 0.19; 95% CI 0.01-3.39, respectively). CONCLUSIONS While having worse prognostic factors compared with glycopeptide-based therapy, linezolid-based salvage therapy revealed a trend toward better outcomes than the comparator. Our data suggest that linezolid-based salvage therapy would be considered in patients with persistent MRSA-B despite the use of glycopeptides therapy.
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Affiliation(s)
- Hyun Jung Park
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kwong JC, Chua K, Charles PGP. Managing Severe Community-Acquired Pneumonia Due to Community Methicillin-Resistant Staphylococcus aureus (MRSA). Curr Infect Dis Rep 2012; 14:330-8. [DOI: 10.1007/s11908-012-0254-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Methicillin-resistant Staphylococcus aureus endocarditis and de novo development of daptomycin resistance during therapy. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2011; 21:89-93. [PMID: 21629617 DOI: 10.1155/2010/618953] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Daptomycin resistance in Staphylococcus aureus has been previously reported, but the development of resistance while on therapy with subsequent clinical failure for endocarditis has been infrequently reported. A case of persistent methicillin-resistant S aureus (MRSA) bacteremia in the setting of right-sided endocarditis in a 38-year-old man with a history of intravenous drug use is presented. He developed de novo resistance to daptomycin during therapy after several courses of antibiotics, with subsequent clinical failure. Isolates were identified by molecular characterization to be community-acquired MRSA 10 (USA300). To the authors' knowledge, the present case was the first in Canada to involve the de novo development of daptomycin resistance with clinical failure due to MRSA during therapy for endocarditis. Clinicians and microbiologists must be aware of this phenomenon given the implications for treatment and transmission of the strain. It also raises questions regarding the use of daptomycin in settings of heavily pretreated patients with persistent MRSA bacteremia.
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Saroglou M, Tryfon S, Ismailos G, Liapakis I, Tzatzarakis M, Tsatsakis A, Papalois A, Bouros D. Pharmacokinetics of Linezolid and Ertapenem in experimental parapneumonic pleural effusion. JOURNAL OF INFLAMMATION-LONDON 2010; 7:22. [PMID: 20482752 PMCID: PMC2890630 DOI: 10.1186/1476-9255-7-22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Accepted: 05/18/2010] [Indexed: 11/11/2022]
Abstract
Objective To determine the extent of linezolid and ertapenem penetration into the empyemic fluid using a rabbit model of empyema. Methods An empyema was created via the intrapleural injection of Escherichia coli bacteria (ATCC 35218) into the pleural space of New Zealand white rabbits. After an empyema was verified by thoracocentesis, 24 hours post inoculation, linezolid (10 mg/kg) and ertapenem (60 mg/kg) were administered intravenously into 10 and 8 infected empyemic rabbits, respectively. Antibiotic levels were determined in samples of pleural fluid and blood serum, collected serially at 1, 2, 4, 6 and 8 hours, after administration each of the two antibiotics. Results Linezolid as well as ertapenem penetrate well into the empyemic pleural fluid, exhibiting a slower onset and decline compared to the corresponding blood serum levels. Equilibration between blood serum and pleural fluid compartments seems to occur at 1.5 hours for both linezolid and ertapenem, with peak pleural fluid levels (Cmaxpf of 2.02 ± 0.73 «mu»g/ml and Cmaxpf of 3.74 ± 1.39 «mu»g/ml, correspondingly) occurring 2 hours post antibiotics administration and decreasing very slowly thereafter. The serum concentrations for both antibiotics were significantly lower from the corresponding pleural fluid ones during the 8 hours collecting data, with the exception of samples collected at the 1st hour (Cmaxserum of 2.1 ± 1.2 «mu»g/ml for linezolid and Cmaxserum of 6.26 ± 2.98 «mu»g/ml for ertapenem). Conclusion Pleural fluid levels of both antibiotics are inhibitory for common specified pathogens causing empyema.
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Affiliation(s)
- Maria Saroglou
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
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18
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Nguyen HM, Graber CJ. Limitations of antibiotic options for invasive infections caused by methicillin-resistant Staphylococcus aureus: is combination therapy the answer? J Antimicrob Chemother 2010; 65:24-36. [PMID: 19861337 DOI: 10.1093/jac/dkp377] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Invasive infections caused by methicillin-resistant Staphylococcus aureus (MRSA), particularly those involving persistent bacteraemia, necrotizing pneumonia, osteomyelitis and other deep-seated sites of infections, are associated with high mortality and are often difficult to treat. The response to treatment of severe MRSA infection with currently available antibiotics active against MRSA is often unsatisfactory, leading some physicians to resort to combination antibiotic therapy. Now, with the emergence of community-associated MRSA (CA-MRSA) clones that display enhanced virulence potentially related to up-regulated toxin production, the use of adjuvant protein synthesis-inhibiting antibiotics to reduce toxin production also has been advocated by some experts. In this review, we discuss the limitations of antibiotics currently available for the treatment of serious invasive MRSA infections and review the existing literature that examines the potential role of combination therapy in these infections.
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Affiliation(s)
- Hien M Nguyen
- Veterans Affairs Greater Los Angeles Healthcare System, CA, USA
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Ceftobiprole is superior to vancomycin, daptomycin, and linezolid for treatment of experimental endocarditis in rabbits caused by methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2009; 54:610-3. [PMID: 19917746 DOI: 10.1128/aac.00886-09] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Beta lactam agents are the most active drugs for the treatment of streptococci and methicillin-susceptible Staphylococcus aureus endocarditis. However, methicillin-resistant S. aureus (MRSA) is resistant to all beta lactam agents licensed to date, and alternative treatments are limited. Ceftobiprole is a novel broad-spectrum cephalosporin that binds with high affinity to PBP 2a, the penicillin binding protein that mediates the methicillin resistance of staphylococci and is active against MRSA. Ceftobiprole was compared to vancomycin, daptomycin, and linezolid in a rabbit model of MRSA aortic valve endocarditis caused by the homogeneously methicillin-resistant laboratory strain COL. Residual organisms in vegetations were significantly fewer in ceftobiprole-treated rabbits than in any other treatment group (P<0.05 for each comparison). In addition, the numbers of organisms in spleens and in kidneys were significantly lower in ceftobiprole-treated rabbits than in linezolid- and vancomycin-treated animals (P<0.05 for each comparison). Anti-MRSA beta lactam agents such as ceftobiprole may represent a significant therapeutic advance over currently available agents for the treatment of MRSA endocarditis.
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Nielsen MD, Mendicino RW, Catanzariti AR. The use of ertapenem for the treatment of lower extremity infections. J Foot Ankle Surg 2009; 48:135-41. [PMID: 19232964 DOI: 10.1053/j.jfas.2008.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Indexed: 02/03/2023]
Abstract
UNLABELLED Lower extremity infections are a growing challenge. Moderate to severe infections are frequently polymicrobial in nature and require appropriate parenteral antibiotic therapy. Ideally, empiric treatment should be broad spectrum in coverage, simplistic in use, and economically reasonable for the patient and the health care system. This article retrospectively reviewed the outcomes of 230 patients, 159 (69.13%) of whom were diabetic, who were admitted with lower extremity infections and who were empirically treated with ertapenem. Ertapenem was well tolerated with a low adverse effect profile. We found a 79.13% rate (182 of 230 patients) of favorable outcome with this regimen, which is comparable to other published studies that have looked at the use of this agent. Ertapenem is a once-daily, broad-spectrum carbapenem antibiotic indicated for the treatment of complicated skin and skin-structure infections (cSSSI). Ertapenem is an appropriate choice for empiric antibiotic therapy of lower extremity infections. LEVEL OF CLINICAL EVIDENCE 2.
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Affiliation(s)
- Matthew D Nielsen
- Department of Foot and Ankle Surgery, The Western Pennsylvania Hospital, Pittsburgh, USA
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Gudiol F, Aguado JM, Pascual A, Pujol M, Almirante B, Miró JM, Cercenado E, Domínguez MDLA, Soriano A, Rodríguez-Baño J, Vallés J, Palomar M, Tornos P, Bouza E. [Consensus document for the treatment of bacteremia and endocarditis caused by methicillin-resistent Staphylococcus aureus. Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica]. Enferm Infecc Microbiol Clin 2009; 27:105-15. [PMID: 19254641 DOI: 10.1016/j.eimc.2008.09.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Accepted: 12/10/2008] [Indexed: 12/15/2022]
Abstract
Bacteremia and endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA) are prevalent and clinically important. The rise in MRSA bacteremia and endocarditis is related with the increasing use of venous catheters and other vascular procedures. Glycopeptides have been the reference drugs for treating these infections. Unfortunately their activity is not completely satisfactory, particularly against MRSA strains with MICs > 1 microg/mL. The development of new antibiotics, such as linezolid and daptomycin, and the promise of future compounds (dalvabancin, ceftobiprole and telavancin) may change the expectatives in this field.The principal aim of this consensus document was to formulate several recommendations to improve the outcome of MRSA bacteremia and endocarditis, based on the latest reported scientific evidence. This document specifically analyzes the approach for three clinical situations: venous catheter-related bacteremia, persistent bacteremia, and infective endocarditis due to MRSA.
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Affiliation(s)
- Francisco Gudiol
- Servicio de Enfermedades Infecciosas, IDIBELL, Hospital Universitario de Bellvitge, Barcelona, España
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Almirante B. Bacteriemia e infecciones endovasculares por grampositivos: nuevas opciones terapéuticas. Enferm Infecc Microbiol Clin 2008. [DOI: 10.1157/13123565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Abstract
This article brings the practicing clinician up to date on the current concepts regarding the medical treatment of diabetic foot infections. Topics include a review of the Infectious Diseases Society of America Practice Guidelines for the Diagnosis and Treatment of Diabetic Foot Infections and a discussion of newer antibiotics such as linezolid, ertapenem, moxifloxacin, dalbavancin, tigecycline, ceftobiprole and iclaprim.
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Affiliation(s)
- Mark A Kosinski
- Department of Medicine, New York College of Podiatric Medicine, 1800 Park Avenue, New York, NY 10035, USA.
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