1
|
Song Y, Zou Y, Xu L, Wang J, Deng X, Zhou Y, Li D. Ginkgolic Acid as a carbapenem synergist against KPC-2 positive Klebsiella pneumoniae. Front Microbiol 2024; 15:1426603. [PMID: 39234551 PMCID: PMC11371739 DOI: 10.3389/fmicb.2024.1426603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 07/22/2024] [Indexed: 09/06/2024] Open
Abstract
The successful evolution of KPC-2 in bacteria has limited the clinical practice of carbapenems. This dilemma deteriorated the prognosis of associated infections and hence attracted increasing attention from researchers to explore alternative therapeutic options. Here, the enzyme inhibition assay was first performed to screen for a potent KPC-2 inhibitor. The synergistic effect of the candidate with carbapenems was further confirmed by checkboard minimum inhibitory concentration (MIC) assay, time-killing assay, disk diffusion method, and live/dead bacteria staining analysis. The mechanisms by which the candidate acts were subsequently explored through molecular dynamics (MD) simulations, etc. Our study found that Ginkgolic Acid (C13:0) (GA) exhibited effective KPC-2 inhibitory activity in both laboratory strain and clinical strain containing KPC-2. It could potentiate the killing effect of carbapenems on KPC-2-positive Klebsiella pnenmoniae (K. pnenmoniae). Further explorations revealed that GA could competitively bind to the active pocket of KPC-2 with meropenem (MEM) via residues Trp104, Gly235, and Leu166. The secondary structure and functional groups of KPC-2 were subsequently altered, which may be the main mechanism by which GA exerted its KPC-2 inhibitory effect. In addition, GA was also found to synergize with MEM to disrupt membrane integrity and increase membrane permeability, which may be another mechanism by which GA reinforced the bactericidal ability of carbapenems. Our study indicated that GA was a significant KPC-2 inhibitor that could prolong the lifespan of carbapenems and improve the prognosis of patients.
Collapse
Affiliation(s)
- Yuping Song
- Department of Respiratory Medicine, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yinuo Zou
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, China
| | - Lei Xu
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, China
| | - Jianfeng Wang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, China
| | - Xuming Deng
- Department of Respiratory Medicine, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun, Jilin, China
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, China
| | - Yonglin Zhou
- Department of Respiratory Medicine, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun, Jilin, China
- Key Laboratory of Ministry of Education for Conservation and Utilization of Special Biological Resources in the Western China, School of Life Sciences, Ningxia University, Yinchuan, China
| | - Dan Li
- Department of Respiratory Medicine, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun, Jilin, China
| |
Collapse
|
2
|
Ye M, Yao L, Lu X, Ding F, Zou D, Tian T, Lin Y, Ning Z, Jiang J, Zhou P. Emergence of Neisseria gonorrhoeae Clone with Reduced Susceptibility to Sitafloxacin in China: An In Vitro and Genomic Study. Antibiotics (Basel) 2024; 13:468. [PMID: 38786196 PMCID: PMC11118021 DOI: 10.3390/antibiotics13050468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
Drug-resistant Neisseria gonorrhoeae poses an urgent threat to public health. Recently, sitafloxacin, a new-generation fluoroquinolone, has shown high in vitro activity against drug-resistant N. gonorrhoeae. However, data on its effectiveness in clinical isolates remains limited. In this study, we collected 507 N. gonorrhoeae isolates from 21 hospitals in Shanghai, China, during 2020 and 2021. Antimicrobial susceptibility testing revealed that sitafloxacin minimum inhibitory concentrations (MICs) exhibited a bimodal distribution, ranging from <0.004 to 2 mg/L. The MIC50 and MIC90 for sitafloxacin were 0.125 mg/L and 0.5 mg/L, respectively, which are 32 and 16 times lower than those for ciprofloxacin (4 mg/L and 8 mg/L, respectively). Sitafloxacin demonstrated high in vitro activity against isolates resistant to either ceftriaxone, azithromycin, or both. Notably, among the isolates with reduced sitafloxacin susceptibility (MIC ≥ MIC90), 83.7% (36/43) were identified as sequence type (ST) 8123. Further phylogenetic analysis showed that ST8123 has evolved into two subclades, designated as subclade-I and subclade-II. A majority of the isolates (80%, 36/45) within subclade-I exhibited reduced susceptibility to sitafloxacin. In contrast, all isolates from subclade-II were found to be susceptible to sitafloxacin. Subsequent genomic investigations revealed that the GyrA-S91F, D95Y, and ParC-S87N mutations, which were exclusively found in ST8123 subclade-I, might be linked to reduced sitafloxacin susceptibility. Our study reveals that sitafloxacin is a promising antibiotic for combating drug-resistant N. gonorrhoeae. However, caution is advised in the clinical application of sitafloxacin for treating N. gonorrhoeae infections due to the emergence of a clone exhibiting reduced susceptibility.
Collapse
Affiliation(s)
- Meiping Ye
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| | - Linxin Yao
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| | - Xinying Lu
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| | - Fangyuan Ding
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| | - Danyang Zou
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| | - Tingli Tian
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| | - Yi Lin
- Division of Tuberculosis and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200051, China
| | - Zhen Ning
- Division of Tuberculosis and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200051, China
| | - Jianping Jiang
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Pingyu Zhou
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| |
Collapse
|
3
|
Sasaki K, Takeshima Y, Fujino A, Yamashita J, Kimoto A, Sasaki D, Kondo A, Akashi M, Okumura R. Construction of a versatile in vitro cultivation screening platform using human oral microbiota. ENVIRONMENTAL MICROBIOLOGY REPORTS 2024; 16:e13243. [PMID: 38425145 PMCID: PMC10904971 DOI: 10.1111/1758-2229.13243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/08/2024] [Indexed: 03/02/2024]
Abstract
We developed a simulation model of human oral microbiota using Bio Palette oral medium (BPOM) containing 0.02% glucose and lower bacterial nitrogen sources, derived from saliva and dental plaque. By decreasing the concentration of Gifu anaerobic medium (GAM) from 30 to 10 g L-1 , we observed increased ratios of target pathogenic genera, Porphyromonas and Fusobacterium from 0.5% and 1.7% to 1.2% and 3.5%, respectively, in the biofilm on hydroxyapatite (HA) discs. BPOM exhibited the higher ratios of Porphyromonas and Fusobacterium, and amplicon sequence variant number on HA, compared with GAM, modified GAM and basal medium mucin. Mixing glycerol stocks of BPOM culture solutions from four human subjects resulted in comparable ratios of these bacteria to the original saliva. In this simulation model, sitafloxacin showed higher inhibitory effects on P. gingivalis than minocycline hydrochloride at a low dosage of 0.1 μg mL-1 . Probiotics such as Streptococcus salivarius and Limosilactobacillus fermentum also showed significant decreases in Porphyromonas and Fusobacterium ratios on HA, respectively. Overall, the study suggests that BPOM with low carbon and nutrients could be a versatile platform for assessing the efficacy of antibiotics and live biotherapeutics in treating oral diseases caused by Porphyromonas and Fusobacterium.
Collapse
Affiliation(s)
| | | | | | - Junya Yamashita
- Department of Oral and Maxillofacial SurgeryKobe University Graduate School of MedicineKobeHyogoJapan
| | - Akira Kimoto
- Department of Oral and Maxillofacial SurgeryKobe University Graduate School of MedicineKobeHyogoJapan
| | - Daisuke Sasaki
- Graduate School of Science, Technology and Innovation, Kobe UniversityKobeHyogoJapan
| | - Akihiko Kondo
- Graduate School of Science, Technology and Innovation, Kobe UniversityKobeHyogoJapan
| | - Masaya Akashi
- Department of Oral and Maxillofacial SurgeryKobe University Graduate School of MedicineKobeHyogoJapan
| | | |
Collapse
|
4
|
Wantanatavatod M, Wongkulab P. Clinical Efficacy of Sitafloxacin-Colistin-Meropenem and Colistin-Meropenem in Patients with Carbapenem-Resistant and Multidrug-Resistant Acinetobacter baumannii Hospital-Acquired Pneumonia (HAP)/Ventilator-Associated Pneumonia (VAP) in One Super-Tertiary Hospital in Bangkok, Thailand: A Randomized Controlled Trial. Antibiotics (Basel) 2024; 13:137. [PMID: 38391523 PMCID: PMC10886248 DOI: 10.3390/antibiotics13020137] [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: 12/24/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Carbapenem-resistant A. baumannii (CRAB) hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) is now a therapeutic problem worldwide. METHOD An open-label, randomized, superiority, single-blind trial was conducted in Rajavithi Hospital, a super-tertiary care facility in Bangkok, Thailand. CRAB HAP/VAP patients were randomly assigned to receive either sitafloxacin-colistin-meropenem or colistin-meropenem. Outcomes in the two groups were then assessed with respect to mortality, clinical response, and adverse effects. RESULT Between April 2021 and April 2022, 77 patients were treated with combinations of either sitafloxacin plus colistin plus meropenem (n = 40) or colistin plus meropenem (n = 37). There were no significant differences between the two groups with respect to all-cause mortality rates at 7 days and 14 days (respectively, 7.5% vs. 2.7%; p = 0.616, and 10% vs. 10%; p = 1). Patients who received sitafloxacin-colistin-meropenem showed improved clinical response compared with patients who received colistin-meropenem in terms of both intention-to-treat (87.5% vs. 62.2%; p = 0.016) and per-protocol analysis (87.2% vs. 67.7%; p = 0.049). There were no significant differences between the two groups with respect to adverse effects. CONCLUSIONS Adding sitafloxacin as a third agent to meropenem plus colistin could improve clinical outcomes in CRAB HAP/VAP with little or no impact on adverse effects. In short, sitafloxacin-meropenem-colistin could be another therapeutic option for combatting CRAB HAP/VAP.
Collapse
Affiliation(s)
- Manasawee Wantanatavatod
- Division of Infectious Disease, Department of Medicine, Rajavithi Hospital, Bangkok 10400, Thailand
| | - Panuwat Wongkulab
- Division of Infectious Disease, Department of Medicine, Rajavithi Hospital, Bangkok 10400, Thailand
| |
Collapse
|
5
|
Guo S, Li X, Li Y, Tong H, Wei M, Yan B, Tian M, Xu B, Shao J. Sitafloxacin pharmacokinetics/pharmacodynamics against multidrug-resistant bacteria in a dynamic urinary tract infection in vitro model. J Antimicrob Chemother 2022; 78:141-149. [PMID: 36329646 DOI: 10.1093/jac/dkac365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Sitafloxacin is one of the newer generation fluoroquinolones with highly active against multidrug-resistant (MDR) bacteria. Our objectives were to identify the sitafloxacin pharmacokinetic/pharmacodynamic (PK/PD) index and breakpoints against MDR isolate in the urinary tract infection model. METHODS Forty-eight MDR isolates underwent sitafloxacin and levofloxacin microdilution susceptibility testing. A 24 h in vitro model was established that simulated the healthy subjects urodynamics of sitafloxacin fumarate injection. Ten MDR isolates (four carbapenem-resistant Escherichia coli, three carbapenem-resistant P. aeruginosa and three vancomycin-resistant E. faecium) were selected. The drug efficacy was quantified by the change in log colony counts within 24 h. A sigmoid Emax model was fitted to the killing effect data. Monte Carlo simulations were performed to assess target attainment for the sitafloxacin fumarate doses of 100 and 200 mg q24h. RESULTS Analysis indicated that the MICs of sitafloxacin were all significantly lower than that of levofloxacin (P < 0.01). The UAUC0-24h/MIC targets required to achieve stasis, 1-log10 killing and 2-log10 killing were 63.60, 79.49 and 99.45 (carbapenem-resistant E. coli), 60.85, 90.31 and 128.95 (carbapenem-resistant P. aeruginosa), 65.91, 77.81 and 103.11 (vancomycin-resistant E. faecium). Monte Carlo simulation showed the infusion of sitafloxacin fumarate 100 mg q24h was able to achieve 90% probability of target attainment against bacteria with MIC of 8 mg/L for the common complicated urinary tract infections. CONCLUSIONS Sitafloxacin fumarate injection is an alternative therapeutic agent for the treatment of UTIs caused by MDR isolates.
Collapse
Affiliation(s)
- Siwei Guo
- The Third Hospital of Changsha, Changsha, Hunan, China.,Institute of Clinical Application of Antibiotics, Changsha, Hunan, China
| | - Xin Li
- The Third Hospital of Changsha, Changsha, Hunan, China.,Institute of Clinical Application of Antibiotics, Changsha, Hunan, China
| | - You Li
- The Third Hospital of Changsha, Changsha, Hunan, China.,Graduate School, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Huan Tong
- The Third Hospital of Changsha, Changsha, Hunan, China.,Institute of Clinical Application of Antibiotics, Changsha, Hunan, China
| | - Minji Wei
- Institute of Clinical Pharmacology, First Hospital, Peking University, Beijing, China
| | - Bingqian Yan
- The Third Hospital of Changsha, Changsha, Hunan, China.,Graduate School, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Miaomei Tian
- The Third Hospital of Changsha, Changsha, Hunan, China.,Graduate School, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Bing Xu
- The Third Hospital of Changsha, Changsha, Hunan, China.,Institute of Clinical Application of Antibiotics, Changsha, Hunan, China
| | - Jing Shao
- Nanjing Yoko Pharmaceutical Co., Ltd, Nanjing, China
| |
Collapse
|
6
|
Antimicrobial activities of sitafloxacin and comparators against the clinical isolates of less common nonfermenting Gram-negative bacteria. J Glob Antimicrob Resist 2022; 30:123-126. [PMID: 35697209 DOI: 10.1016/j.jgar.2022.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022] Open
Abstract
The in vitro antimicrobial activities of sitafloxacin and comparators against 320 clinical isolates of less common nonfermenting Gram-negative bacteria (NFGNB) were assessed by determining the minimum inhibitory concentrations (MICs) using broth microdilution method. In terms of MIC50/90 values, sitafloxacin was highly active against Stenotrophomonas maltophilia (0.25/1 mg/L), Burkholderia cepacia complex (0.25/2 mg/L), Achromobacter xylosoxidans (0.25/1 mg/L), and Chryseobacterium gleum (1/2 mg/L), but less active for Elizabethkingia (1/8 mg/L) and Chryseobacterium indologenes (16/32 mg/L). Sitafloxacin was more active than other fluoroquinolones against these NFGNB except Chryseobacterium. The results are helpful for clinicians to be aware of the role of sitafloxacin in managing the infections caused by these NFGNB.
Collapse
|