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Cusack R, Garduno A, Elkholy K, Martín-Loeches I. Novel investigational treatments for ventilator-associated pneumonia and critically ill patients in the intensive care unit. Expert Opin Investig Drugs 2022; 31:173-192. [PMID: 35040388 DOI: 10.1080/13543784.2022.2030312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Ventilator-associated pneumonia (VAP) is common; its prevalence has been highlighted by the Covid-19 pandemic. Even young patients can suffer severe nosocomial infection and prolonged mechanical ventilation. Multidrug-resistant bacteria can spread alarmingly fast around the globe and new antimicrobials are struggling to keep pace; hence physicians must stay abreast of new developments in the treatment of nosocomial pneumonia and VAP. AREAS COVERED This narrative review examines novel antimicrobial investigational drugs and their implementation in the ICU setting for VAP. The paper highlights novel approaches such as monoclonal antibody treatments for P. aeruginosa and S. aureus, and phage antibiotic synthesis. The paper also examines mechanisms of resistance in gram-negative bacteria, virulence factors and inhaled antibiotics and questions what may be on the horizon in terms of emerging treatment strategies. EXPERT OPINION The post-antibiotic era is rapidly approaching and the need for personalised medicine, point-of-care microbial sensitivity testing and development of biomarkers for severe infections is clear. Results from emerging and new antibiotics are encouraging, but infection control measures and de-escalation protocols must be employed to prolong their usefulness in critical illness.
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Affiliation(s)
- Rachael Cusack
- Department of Clinical Medicine, Trinity College Dublin.,Department of Intensive Care Medicine, St. James's Hospital, Dublin, (Ireland)
| | - Alexis Garduno
- Department of Clinical Medicine, Trinity College Dublin.,Intensive Care Translational Research, Trinity College Dublin
| | - Khalid Elkholy
- Department of Intensive Care Medicine, St. James's Hospital, Dublin, (Ireland)
| | - Ignacio Martín-Loeches
- Department of Clinical Medicine, Trinity College Dublin.,Department of Intensive Care Medicine, St. James's Hospital, Dublin, (Ireland).,Multidisciplinary Intensive Care Research Organization (MICRO), St. James's Hospital, Dublin, (Ireland)
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Identification and antimicrobial susceptibility profiles of Nocardia species clinically isolated in Japan. Sci Rep 2021; 11:16742. [PMID: 34408177 PMCID: PMC8373947 DOI: 10.1038/s41598-021-95870-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 08/02/2021] [Indexed: 01/31/2023] Open
Abstract
The aims of the present study were to profile the antimicrobial susceptibility patterns of a diverse range of Nocardia species isolated in Japan, and to determine the ability of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for species/complex identification. Identification of 153 clinical isolates was performed by full-length 16S rRNA gene sequencing as a reference method to evaluate the usefulness of MALDI-TOF MS identification. Antimicrobial susceptibility testing (AST) for 14 antibiotics was performed using the broth microdilution method against 146 of the isolates. Among the total 153 clinical isolates, Nocardia farcinica complex (25%) was the most common species, followed by Nocardia cyriacigeorgica (18%), Nocardia brasiliensis (9%), Nocardia nova (8%), and Nocardia otitidiscaviarum (7%). Among 150 isolates identified to the species/complex level by 16S rRNA gene sequencing, MALDI-TOF MS with the use of a supplemental Nocardia library (JMLD library ver.ML01) correctly identified 97.3% (n = 146) to the species/complex level and 1.3% (n = 2) to the genus level. Among the 146 Nocardia isolates that underwent AST, the susceptibilities were 100% to linezolid, 96% to amikacin, 94% to trimethoprim-sulfamethoxazole, and 76% to imipenem. None of the trimethoprim-sulfamethoxazole-resistant isolates carried either plasmid-mediated sulfonamide-resistant genes (sul1, sul2) or trimethoprim-resistant genes (dfrA).
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Daniele-Silva A, Rodrigues SDCS, Dos Santos ECG, Queiroz Neto MFD, Rocha HADO, Silva-Júnior AAD, Resende JM, Araújo RM, Fernandes-Pedrosa MDF. NMR three-dimensional structure of the cationic peptide Stigmurin from Tityus stigmurus scorpion venom: In vitro antioxidant and in vivo antibacterial and healing activity. Peptides 2021; 137:170478. [PMID: 33359395 DOI: 10.1016/j.peptides.2020.170478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 01/05/2023]
Abstract
Infectious diseases and the rapid development of pathogens resistant to conventional drugs are a serious global public health problem, which motivates the search for new pharmacological agents. In this context, cationic peptides without disulfide bridges from different species of scorpion venom have been the target of scientific studies due to their multifunctional activities. Stigmurin is a linear peptide composed of 17 amino acid residues (Phe-Phe-Ser-Leu-Ile-Pro-Ser-Leu-Val-Gly-Gly-Leu-Ile-Ser-Ala-Phe-Lys-NH2), which is present in the venom gland of the scorpion Tityus stigmurus. Here we present investigations of the in vitro antioxidant action of Stigmurin together with the in vivo antibacterial and healing activity of this peptide in a wound infection model induced by Staphylococcus aureus. In addition, we have reports for the first time of the three-dimensional structure determined by NMR spectroscopy of a peptide without disulfide bridges present in scorpion venom from the Tityus genus. Stigmurin showed hydroxyl radical scavenging above 70 % at 10 μM and antibiotic action in the skin wound, reducing the number of viable microorganisms by 67.2 % on the 7 day after infection. Stigmurin (1 μg / μL) increased the retraction rate of the lesion, with wound area reduction of 43 % on the second day after skin injury, which indicates its ability to induce tissue repair. Stigmurin in trifluoroethanol:water exhibited a random conformation at the N-terminus region (Phe1 to Pro6), with a helical structure from Ser7 to Phe16. This structural information, allied with the multifunctional activity of Stigmurin, makes it an attractive candidate for the design of novel therapeutic agents.
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Affiliation(s)
- Alessandra Daniele-Silva
- Laboratório de Tecnologia e Biotecnologia Farmacêutica, Departamento de Farmácia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Suedson de Carvalho Silva Rodrigues
- Laboratório de Isolamento e Síntese de Compostos Orgânicos, Instituto de Química, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | | | - Moacir Fernandes de Queiroz Neto
- Laboratório de Biotecnologia de Polímeros Naturais, Departamento de Bioquímica, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Hugo Alexandre de Oliveira Rocha
- Laboratório de Biotecnologia de Polímeros Naturais, Departamento de Bioquímica, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Arnóbio Antônio da Silva-Júnior
- Laboratório de Tecnologia e Biotecnologia Farmacêutica, Departamento de Farmácia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Jarbas Magalhães Resende
- Laboratório de Síntese e Estrutura de Peptídeos, Departamento de Química, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Renata Mendonça Araújo
- Laboratório de Isolamento e Síntese de Compostos Orgânicos, Instituto de Química, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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Pharmacokinetic-Pharmacodynamic Target Attainment Analyses To Support Dose Selection for ME1100, an Arbekacin Inhalation Solution. Antimicrob Agents Chemother 2020; 64:AAC.02367-19. [PMID: 32661000 DOI: 10.1128/aac.02367-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 07/03/2020] [Indexed: 11/20/2022] Open
Abstract
ME1100 (arbekacin inhalation solution) is an inhaled aminoglycoside that is being developed to treat patients with hospital-acquired and ventilator-associated bacterial pneumonia (HABP and VABP, respectively). Pharmacokinetic-pharmacodynamic (PK-PD) target attainment analyses were undertaken to evaluate ME1100 regimens for the treatment of patients with HABP/VABP. The data used included a population pharmacokinetic (PPK) 4-compartment model with 1st-order elimination, nonclinical PK-PD targets from one-compartment in vitro and/or in vivo infection models, and in vitro surveillance data. Using the PPK model, total-drug epithelial lining fluid (ELF) concentration-time profiles were generated for simulated patients with varying creatinine clearance (CLcr) (ml/min/1.73 m2) values. Percent probabilities of PK-PD target attainment by MIC were determined based on the ratio of total-drug ELF area under the concentration-time curve (AUC) to MIC (AUC/MIC ratio) targets associated with 1- and 2-log10 CFU reductions from baseline for Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus Percent probabilities of PK-PD target attainment based on PK-PD targets for a 1-log10 CFU reduction from baseline at MIC values above the MIC90 value for K. pneumoniae (8 μg/ml), P. aeruginosa (4 μg/ml), and S. aureus (0.5 μg/ml) were ≥99.8% for ME1100 600 mg twice daily (BID) in simulated patients with CLcr values >80 to ≤120 ml/min/1.73 m2 ME1100 600 mg BID, 450 mg BID, and 600 mg once daily in simulated patients with CLcr values >50 to ≤80, >30 to ≤50, and 0 to ≤30 ml/min/1.73 m2, respectively, provided arbekacin exposures that best matched those for 600 mg BID in simulated patients with normal renal function. These data provide support for ME1100 as a treatment for patients with HABP/VABP.
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Anti-staphylococcal activity resulting from epithelial lining fluid (ELF) concentrations of amikacin inhale administered via the pulmonary drug delivery system. Ann Clin Microbiol Antimicrob 2017; 16:2. [PMID: 28095918 PMCID: PMC5240302 DOI: 10.1186/s12941-017-0178-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 01/03/2017] [Indexed: 01/13/2023] Open
Abstract
Background Amikacin inhale (BAY41-6551), a unique drug—device combination of a specially formulated drug solution and a pulmonary drug delivery system device (AMK-I) is currently under phase III study as an adjunctive therapy to IV antibiotics for the treatment of Gram-negative pneumonia in mechanically ventilated patients. While the epidemiology of nosocomial pneumonia is predominated by Gram-negative pathogens such as Pseudomonas aeruginosa and the Enterobacteriaceae, Staphylococcus aureus is increasingly recognized as a pathogen of concern for these pulmonary based infections. Since the aminoglycosides are historically quite active against S. aureus the use of adjunctive AMK-I may enhance bacterial eradication. Herein, we aimed to characterize the in vitro pharmacodynamic (PD) profile of human-simulated ELF exposures of AMK-I against both methicillin-sensitive (MSSA) and -resistant (MRSA) S. aureus. Methods An in vitro model was used to simulate the resultant ELF pharmacokinetic profile of amikacin after the administration of AMK-I 400 mg q12h. The antibacterial activity of this regimen was tested against 7 S. aureus isolates that display MIC profiles encountered clinically (4 MRSA; MIC range 4–64, 3 MSSA; MIC range 8–16 mg/L). Experiments were conducted over 24 h and samples were taken throughout this period to assess the bacterial density in both control and treatments. Results The mean ± SD inoculum 0 h bacterial density was 6.4 ± 0.09 which increased to 8.6 ± 0.19 log10 CFU/mL in the control models by the end of 24 h experiments. Simulated ELF concentrations of AMK-I resulted in a rapid, 5 log10 declined in CFU over the initial 12 h for all MRSA and MSSA isolates. After 12 h, all bacterial counts remained below the limit of detection (LOD, 1.7 log10 CFU/mL) and no regrowth was evident at the end of the study. Conclusion AMK-I produced an ELF exposure profile that was rapidly bactericidal against S. aureus displaying typical MICs to amikacin irrespective of their phenotypic profile to methicillin. While the Gram-negative organisms are the target pathogens for AMK-I in the ongoing clinical trials, these data suggest that this adjunctive regimen may also have the potential to eradicate both MSSA and MRSA from lower airway which needs to be further evaluated in randomized-controlled clinical trials.
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Wilkes S, Burden‐Teh E, Robertson F, Grindlay D, Selby N. Skin and soft tissue infections and acute kidney injury: a systematic review. Br J Dermatol 2016; 175:182-4. [DOI: 10.1111/bjd.14368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- S.R. Wilkes
- Centre of Evidence‐Based Dermatology School of Medicine University of Nottingham Nottingham U.K
| | - E. Burden‐Teh
- Centre of Evidence‐Based Dermatology School of Medicine University of Nottingham Nottingham U.K
| | - F. Robertson
- Division of Medical Sciences and Graduate Entry Medicine University of Nottingham Nottingham U.K
| | - D. Grindlay
- Centre of Evidence‐Based Dermatology School of Medicine University of Nottingham Nottingham U.K
| | - N.M. Selby
- Division of Medical Sciences and Graduate Entry Medicine University of Nottingham Nottingham U.K
- Department of Renal Medicine Royal Derby Hospital Derby U.K
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Hwang JH, Lee JH, Kim JS, Hwang JH, Lee CS. Arbekacin as an Alternative Drug to Teicoplanin for the Treatment of MRSA Infection. Yonsei Med J 2016; 57:1047-8. [PMID: 27189305 PMCID: PMC4951450 DOI: 10.3349/ymj.2016.57.4.1047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 08/20/2015] [Accepted: 08/27/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ji Hee Hwang
- Department of Pharmacy, Chonbuk National University Hospital, Jeonju, Korea
| | - Ju Hyung Lee
- Department of Preventive Medicine, Chonbuk National University, Jeonju, Korea
| | - Ju Sin Kim
- Department of Pharmacy, Chonbuk National University Hospital, Jeonju, Korea
| | - Jeong Hwan Hwang
- Department of Internal Medicine, Chonbuk National University, Jeonju, Korea
- Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea
- Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Chang Seop Lee
- Department of Internal Medicine, Chonbuk National University, Jeonju, Korea
- Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea
- Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
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Abstract
Arbekacin is a broad-spectrum aminoglycoside used to treat methicillin-resistant Staphylococcus aureus (MRSA). Arbekacin has antibacterial activities against high-level gentamicin-resistant Enterococci, multidrug-resistant Pseudomonas aeruginosa, and Acinetobacter baumannii et al. Here, we reviewed in vitro data on arbekacin in Staphylococci and Gram-negative microorganisms. We also reviewed clinical studies for clinical efficacy and microbiologic efficacy data in patients with identified MRSA and suspected MRSA infections. The overall clinical efficacy ranged from 66.7% to 89.7%. The microbiologic efficacy rate ranged from 46.2% to 83%. In comparative studies between arbekacin and glycopeptides, arbekacin was similar to other glycopeptides with respect to clinical and microbiological efficacy rates. Combination trials with other antibiotics suggest that arbekacin will be a promising strategy to control Enterococcus spp. multi-drug resistant P. aeruginosa. The major adverse reaction was nephrotoxicity/hepatotoxicity, but patients recovered from most adverse reactions without any severe complications. Based on these results, arbekacin could be a good alternative to vancomycin/teicoplanin in MRSA treatment. Finally, therapeutic drug monitoring is recommended to maximize clinical efficacy and decrease nephrotoxicity.
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Affiliation(s)
- Jae Hoon Lee
- Department of Internal Medicine, Wonkwang University Medical School, Iksan, Korea
| | - Chang-Seop Lee
- Department of Internal Medicine, Chonbuk National University, Jeonju, Korea.; Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea.; Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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Clinical efficacy and safety of arbekacin for high-risk infections in patients with hematological malignancies. Int J Hematol 2015; 103:334-40. [PMID: 26715149 DOI: 10.1007/s12185-015-1926-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 12/07/2015] [Accepted: 12/11/2015] [Indexed: 10/22/2022]
Abstract
We performed a clinical trial to investigate the efficacy and safety of arbekacin (ABK), a unique aminoglycoside with activity against methicillin-resistant Staphylococcus aureus (MRSA), in patients with hematological malignancies complicated by high-risk infections. ABK was administered intravenously at a dose of approximately 5 mg/kg with various broad-spectrum β-lactams, followed by therapeutic drug monitoring (TDM). A total of 54 febrile or infectious episodes were registered, and TDM was performed in 44 (81%) cases. The absolute neutrophil count was below 500/μl in 49 (91%) cases, and cytotoxic chemotherapy was being administered in 47 (87%) cases. Before initiation of ABK, 52 (96%) patients had received fluoroquinolones (n = 37) and/or broad-spectrum β-lactams (n = 34). There were 10 cases of documented infections including one of MRSA pneumonia, and 44 cases of febrile neutropenia. The efficacy at the end of treatment was 80% for all patients, and efficacy was significantly higher in patients attaining maximum concentrations ≥ 16 µg/ml or receiving TDM-guided dose-adjustment of ABK (n = 19, 95 vs. 71%, P = 0.039). Renal toxicity was observed in six cases (11%) but was generally acceptable. This study demonstrated that TDM-guided ABK administration may be applicable under limited conditions for patients with hematological malignancies.
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Hwang JH, Lee JH, Hwang JH, Chung KM, Lee EJ, Yoon YJ, Moon MK, Kim JS, Won KS, Lee CS. Comparison of Arbekacin and Vancomycin in Treatment of Chronic Suppurative Otitis Media by Methicillin Resistant Staphylococcus aureus. J Korean Med Sci 2015; 30:688-93. [PMID: 26028918 PMCID: PMC4444466 DOI: 10.3346/jkms.2015.30.6.688] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 03/18/2015] [Indexed: 11/25/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of ear infections. We attempted to evaluate the clinical usefulness of arbekacin in treating chronic suppurative otitis media (CSOM) by comparing its clinical efficacy and toxicity with those of vancomycin. Efficacy was classified according to bacterial elimination or bacteriologic failure and improved or failed clinical efficacy response. Ninety-five subjects were diagnosed with CSOM caused by MRSA. Twenty of these subjects were treated with arbekacin, and 36 with vancomycin. The bacteriological efficacy (bacterial elimination, arbekacin vs. vancomycin: 85.0% vs. 97.2%) and improved clinical efficacy (arbekacin vs. vancomycin; 90.0% vs. 97.2%) were not different between the two groups. However, the rate of complications was higher in the vancomycin group (33.3%) than in the arbekacin group (5.0%) (P=0.020). In addition, a total of 12 adverse reactions were observed in the vancomycin group; two for hepatotoxicity, one for nephrotoxicity, eight for leukopenia, two for skin rash, and one for drug fever. It is suggested that arbekacin be a good alternative drug to vancomycin in treatment of CSOM caused by MRSA.
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Affiliation(s)
- Ji-Hee Hwang
- Department of Pharmacy, Chonbuk National University Hospital, Jeonju, Korea
| | - Ju-Hyung Lee
- Department of Preventive Medicine, Chonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Jeonju, Korea
| | - Jeong-Hwan Hwang
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Kyung Min Chung
- Department of Microbiology & Immunology, Chonbuk National University Medical School, Jeonju, Korea
| | - Eun-Jung Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonbuk National University Medical School, Jeonju, Korea
| | - Yong-Joo Yoon
- Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Jeonju, Korea
- Department of Otolaryngology-Head and Neck Surgery, Chonbuk National University Medical School, Jeonju, Korea
| | - Mi-Kyoung Moon
- Department of Pharmacy, Chonbuk National University Hospital, Jeonju, Korea
| | - Ju-Sin Kim
- Department of Pharmacy, Chonbuk National University Hospital, Jeonju, Korea
| | - Kyoung-Suk Won
- Department of Pharmacy, Chonbuk National University Hospital, Jeonju, Korea
| | - Chang-Seop Lee
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Jeonju, Korea
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Arbekacin activity against contemporary clinical bacteria isolated from patients hospitalized with pneumonia. Antimicrob Agents Chemother 2015; 59:3263-70. [PMID: 25801559 DOI: 10.1128/aac.04839-14] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/15/2015] [Indexed: 12/13/2022] Open
Abstract
Arbekacin is a broad-spectrum aminoglycoside licensed for systemic use in Japan and under clinical development as an inhalation solution in the United States. We evaluated the occurrence of organisms isolated from pneumonias in U.S. hospitalized patients (PHP), including ventilator-associated pneumonia (VAP), and the in vitro activity of arbekacin. Organism frequency was evaluated from a collection of 2,203 bacterial isolates (339 from VAP) consecutively collected from 25 medical centers in 2012 through the SENTRY Antimicrobial Surveillance Program. Arbekacin activity was tested against 904 isolates from PHP collected in 2012 from 62 U.S. medical centers and 303 multidrug-resistant (MDR) organisms collected worldwide in 2009 and 2010 from various infection types. Susceptibility to arbekacin and comparator agents was evaluated by the reference broth microdilution method. The four most common organisms from PHP were Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella spp., and Enterobacter spp. The highest arbekacin MIC among S. aureus isolates from PHP (43% methicillin-resistant S. aureus [MRSA]) was 4 μg/ml. Among P. aeruginosa isolates from PHP, only one had an arbekacin MIC of >16 μg/ml (MIC50 and MIC90, 1 and 4 μg/ml), and susceptibility rates for gentamicin, tobramycin, and amikacin were 88.0, 90.0, and 98.0%, respectively. Arbekacin (MIC50, 2 μg/ml) and tobramycin (MIC50, 4 μg/ml) were the most potent aminoglycosides tested against Acinetobacter baumannii. Against Enterobacteriaceae from PHP, arbekacin and gentamicin (MIC50 and MIC90, 0.25 to 1 and 1 to 8 μg/ml for both compounds) were generally more potent than tobramycin (MIC50 and MIC90, 0.25 to 2 and 1 to 32 μg/ml) and amikacin (MIC50 and MIC90, 1 to 2 and 2 to 32 μg/ml). Arbekacin also demonstrated potent in vitro activity against a worldwide collection of well-characterized MDR Gram-negative and MRSA strains.
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Fensterseifer ICM, Silva ON, Malik U, Ravipati AS, Novaes NRF, Miranda PRR, Rodrigues EA, Moreno SE, Craik DJ, Franco OL. Effects of cyclotides against cutaneous infections caused by Staphylococcus aureus. Peptides 2015; 63:38-42. [PMID: 25451333 DOI: 10.1016/j.peptides.2014.10.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 10/31/2014] [Accepted: 10/31/2014] [Indexed: 12/31/2022]
Abstract
The main bacterium associated with skin infection is Staphylococcus aureus, occurring especially in infections acquired via surgical wounds, commonly leading to lethal hospital-acquired infections, emphasizing the importance of identifying new antimicrobial compounds. Among them, cyclotides have gained interest due to their high stability and multifunctional properties. Here, cycloviolacin 2 (CyO2) and kalata B2 (KB2) were evaluated to determinate their anti-staphylococcal activities using a subcutaneous infection model. Anti-staphylococcal activities of 50mM for KB2 and 25mM for CyO2 were detected with no cytotoxic activities against RAW 264.7 monocytes. In the in vivo assays, both cyclotides reduced bacterial load and CyO2 demonstrated an increase in the phagocytosis index, suggesting that the CyO2 in vivo anti-staphylococcal activity may be associated with phagocytic activity, additionally to direct anti-pathogenic activity.
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Affiliation(s)
- Isabel C M Fensterseifer
- Centro de Análises, Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, 70790-160 Brazil; Molecular Pathology Post-graduate Program, University of Brasilia, Brasília 70910-900, Brazil
| | - Osmar N Silva
- Centro de Análises, Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, 70790-160 Brazil; Department of Biology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil
| | - Uru Malik
- Institute for Molecular Bioscience, the University of Queensland, Brisbane, Queensland, Australia
| | - Anjaneya S Ravipati
- Institute for Molecular Bioscience, the University of Queensland, Brisbane, Queensland, Australia
| | - Natasha R F Novaes
- Centro de Análises, Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, 70790-160 Brazil
| | - Paulo R R Miranda
- Centro de Análises, Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, 70790-160 Brazil
| | - Elaine A Rodrigues
- Centro de Análises, Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, 70790-160 Brazil
| | - Susana E Moreno
- Centro de Análises, Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, 70790-160 Brazil
| | - David J Craik
- Institute for Molecular Bioscience, the University of Queensland, Brisbane, Queensland, Australia
| | - Octavio L Franco
- Centro de Análises, Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, 70790-160 Brazil; Molecular Pathology Post-graduate Program, University of Brasilia, Brasília 70910-900, Brazil; Department of Biology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil; S-Inova, Pos-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Caampo Grande, MS, Brazil.
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Matsumoto T. Arbekacin: another novel agent for treating infections due to methicillin-resistant Staphylococcus aureus and multidrug-resistant Gram-negative pathogens. Clin Pharmacol 2014; 6:139-48. [PMID: 25298740 PMCID: PMC4186621 DOI: 10.2147/cpaa.s44377] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Arbekacin sulfate (ABK), an aminoglycoside antibiotic, was discovered in 1972 and was derived from dibekacin to stabilize many common aminoglycoside modifying enzymes. ABK shows broad antimicrobial activities against not only Gram-positive bacteria including methicillin-resistant Staphylococcus aureus (MRSA) but also Gram-negative bacteria such as Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae. ABK has been approved as an injectable formulation in Japan since 1990, under the trade name Habekacin, for the treatment of patients with pneumonia and sepsis caused by MRSA. The drug has been used in more than 250,000 patients, and its clinical benefit and safety have been proven over two decades. ABK currently shows promise for the application for the treatment of multidrug-resistant Gram-negative bacterial infections such as multidrug-resistant strains of P. aeruginosa and Acinetobacter baumannii because of its synergistic effect in combination with beta-lactams.
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