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Hidalgo-Tenorio C, Pitto-Robles I, Arnés García D, de Novales FJM, Morata L, Mendez R, de Pablo OB, López de Medrano VA, Lleti MS, Vizcarra P, Lora-Tamayo J, Arnáiz García A, Núñez LM, Masiá M, Seco MPR, Sadyrbaeva-Dolgova S. Cefto Real-Life Study: Real-World Data on the Use of Ceftobiprole in a Multicenter Spanish Cohort. Antibiotics (Basel) 2023; 12:1218. [PMID: 37508314 PMCID: PMC10376387 DOI: 10.3390/antibiotics12071218] [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: 06/19/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Ceftobiprole is a fifth-generation cephalosporin that has been approved in Europe solely for the treatment of community-acquired and nosocomial pneumonia. The objective was to analyze the use of ceftobiprole medocaril (Cefto-M) in Spanish clinical practice in patients with infections in hospital or outpatient parenteral antimicrobial therapy (OPAT). METHODS This retrospective, observational, multicenter study included patients treated from 1 September 2021 to 31 December 2022. RESULTS A total of 249 individuals were enrolled, aged 66.6 ± 15.4 years, of whom 59.4% were male with a Charlson index of four (IQR 2-6), 13.7% had COVID-19, and 4.8% were in an intensive care unit (ICU). The most frequent type of infection was respiratory (55.8%), followed by skin and soft tissue infection (21.7%). Cefto-M was administered to 67.9% of the patients as an empirical treatment, in which was administered as monotherapy for 7 days (5-10) in 53.8% of cases. The infection-related mortality was 11.2%. The highest mortality rates were identified for ventilator-associated pneumonia (40%) and infections due to methicillin-resistant Staphylococus aureus (20.8%) and Pseudomonas aeruginosa (16.1%). The mortality-related factors were age (OR: 1.1, 95%CI (1.04-1.16)), ICU admission (OR: 42.02, 95%CI (4.49-393.4)), and sepsis/septic shock (OR: 2.94, 95%CI (1.01-8.54)). CONCLUSIONS In real life, Cefto-M is a safe antibiotic, comprising only half of prescriptions for respiratory infections, that is mainly administered as rescue therapy in pluripathological patients with severe infectious diseases.
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Affiliation(s)
- Carmen Hidalgo-Tenorio
- Unit of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18012 Granada, Spain
| | - Inés Pitto-Robles
- Unit of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18012 Granada, Spain
| | - Daniel Arnés García
- Unit of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18012 Granada, Spain
| | | | - Laura Morata
- Infectious Diseases Service, Hospital Clinic, 08036 Barcelona, Spain
| | - Raul Mendez
- Pneumology Deparment, Hospital Universitario La Fe, Valencia (CIBERES), 46026 Valencia, Spain
| | | | | | - Miguel Salavert Lleti
- Infectious Diseases Service, Hospital Universitario La Fe, Valencia (CIBERES), 46026 Valencia, Spain
| | - Pilar Vizcarra
- Infectious Diseases Service, Hospital Ramón y Cajal, 28034 Madrid, Spain
| | - Jaime Lora-Tamayo
- Internal Medicine Service, Hospital Universitario 12 Octubre (CIBERINFEC), 28041 Madrid, Spain
| | - Ana Arnáiz García
- Department of Infectious Diseases, Hospital Sierrallana, 39300 Torrelavega, Spain
| | - Leonor Moreno Núñez
- Internal Medicine Service, Hospital Fundación de Alcorcón, 28922 Alcorcón, Spain
| | - Mar Masiá
- Infectious Diseases Service, Hospital Universitario General of Elche, 03203 Elche, Spain
| | | | - Svetlana Sadyrbaeva-Dolgova
- Pharmacy Service, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18012 Granada, Spain
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Efficacy of Omadacycline against Escherichia coli in a Mouse Urinary Tract Infection Model. Antimicrob Agents Chemother 2021; 65:e0026921. [PMID: 33972239 DOI: 10.1128/aac.00269-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In a mouse urinary tract infection model, omadacycline (OMC) was comparable to gentamicin and better than ciprofloxacin (CIP) against a tetracycline-susceptible (TET-S), CIP-resistant (CIP-R) Escherichia coli strain. Gentamicin showed better efficacy than OMC against a TET-R, CIP-R E. coli strain, and OMC again showed better efficacy than CIP against this strain. OMC may warrant further study as a potential option for urinary tract infection treatment against CIP-R E. coli strains.
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Xu L, Surathu A, Raplee I, Chockalingam A, Stewart S, Walker L, Sacks L, Patel V, Li Z, Rouse R. The effect of antibiotics on the gut microbiome: a metagenomics analysis of microbial shift and gut antibiotic resistance in antibiotic treated mice. BMC Genomics 2020; 21:263. [PMID: 32228448 PMCID: PMC7106814 DOI: 10.1186/s12864-020-6665-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/10/2020] [Indexed: 02/08/2023] Open
Abstract
Background Emergence of antibiotic resistance is a global public health concern. The relationships between antibiotic use, the gut community composition, normal physiology and metabolism, and individual and public health are still being defined. Shifts in composition of bacteria, antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs) after antibiotic treatment are not well-understood. Methods This project used next-generation sequencing, custom-built metagenomics pipeline and differential abundance analysis to study the effect of antibiotic monotherapy on resistome and taxonomic composition in the gut of Balb/c mice infected with E. coli via transurethral catheterization to investigate the evolution and emergence of antibiotic resistance. Results There is a longitudinal decrease of gut microbiota diversity after antibiotic treatment. Various ARGs are enriched within the gut microbiota despite an overall reduction of the diversity and total amount of bacteria after antibiotic treatment. Sometimes treatment with a specific class of antibiotics selected for ARGs that resist antibiotics of a completely different class (e.g. treatment of ciprofloxacin or fosfomycin selected for cepA that resists ampicillin). Relative abundance of some MGEs increased substantially after antibiotic treatment (e.g. transposases in the ciprofloxacin group). Conclusions Antibiotic treatment caused a remarkable reduction in diversity of gut bacterial microbiota but enrichment of certain types of ARGs and MGEs. These results demonstrate an emergence of cross-resistance as well as a profound change in the gut resistome following oral treatment of antibiotics.
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Affiliation(s)
- Lei Xu
- U. S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Translational Science, Office of Clinical Pharmacology, Division of Applied Regulatory Science, HFD-910, White Oak Federal Research Center, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
| | - Anil Surathu
- U. S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Translational Science, Office of Clinical Pharmacology, Division of Applied Regulatory Science, HFD-910, White Oak Federal Research Center, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
| | - Isaac Raplee
- U. S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Translational Science, Office of Clinical Pharmacology, Division of Applied Regulatory Science, HFD-910, White Oak Federal Research Center, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
| | - Ashok Chockalingam
- U. S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Translational Science, Office of Clinical Pharmacology, Division of Applied Regulatory Science, HFD-910, White Oak Federal Research Center, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
| | - Sharron Stewart
- U. S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Translational Science, Office of Clinical Pharmacology, Division of Applied Regulatory Science, HFD-910, White Oak Federal Research Center, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
| | - Lacey Walker
- U. S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Translational Science, Office of Clinical Pharmacology, Division of Applied Regulatory Science, HFD-910, White Oak Federal Research Center, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
| | - Leonard Sacks
- U. S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Medical Policy, White Oak Federal Research Center, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
| | - Vikram Patel
- U. S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Translational Science, Office of Clinical Pharmacology, Division of Applied Regulatory Science, HFD-910, White Oak Federal Research Center, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
| | - Zhihua Li
- U. S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Translational Science, Office of Clinical Pharmacology, Division of Applied Regulatory Science, HFD-910, White Oak Federal Research Center, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
| | - Rodney Rouse
- U. S. Food and Drug Administration, Center for Drug Evaluation and Research, Office of Translational Science, Office of Clinical Pharmacology, Division of Applied Regulatory Science, HFD-910, White Oak Federal Research Center, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA.
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Tascini C, Attanasio V, Ripa M, Carozza A, Pallotto C, Bernardo M, Francisci D, Oltolini C, Palmiero G, Scarpellini P. Ceftobiprole for the treatment of infective endocarditis: A case series. J Glob Antimicrob Resist 2019; 20:56-59. [PMID: 31351247 DOI: 10.1016/j.jgar.2019.07.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 07/15/2019] [Accepted: 07/17/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Ceftobiprole is a relatively new cephalosporin with broad-spectrum activity and good tolerability. Despite its promising characteristics, to our knowledge, only two case reports, previously published also by some of us, is available concerning its administration for the treatment of infective endocarditis. Hereby we report our experience in this field. METHODS All the patients with infective endocarditis treated with ceftobiprole were enrolled. RESULTS 12 cases of endocarditis were treated with ceftobiprole, 11/12 in combination with daptomycin and 1/12 as monotherapy. Gram-positive bacteria were isolated in 12/12 patients; 3 cases were polymicrobial. Cure rate was 83% (10/12 patients). In 9/12 (75%) cases, patients were switched to ceftobiprole following failure of previous antimicrobial regimen. In 3/3 patients in which ceftobiprole was administered because of persistently positive blood culture, bacteraemia clearance was rapidly achieved. CONCLUSIONS Ceftobiprole, especially in combination, could be a promising alternative treatment for infective endocarditis.
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Affiliation(s)
- Carlo Tascini
- First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, via Bianchi snc, Naples, Italy.
| | - Vittorio Attanasio
- First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, via Bianchi snc, Naples, Italy.
| | - Marco Ripa
- Department of Infectious Disease, San Raffaele Hospital, via Stamira d'Ancona, Milan, Italy.
| | - Antonio Carozza
- UOSD Advanced Techniques in Cardiosurgery, Monaldi Hospital, AORN dei Colli, via Bianchi, snc, Naples, Italy.
| | - Carlo Pallotto
- Section of Infectious Diseases, Department of Medicine, University of Perugia, Piazzale Gambuli, 1, Perugia, Italy; UOC Infectious Diseases, San Donato Hospital, Azienda USL Toscana Sud Est, via Nenni, 22, Arezzo, Italy.
| | - Mariano Bernardo
- Microbiology and Virology Unit, Cotugno Hospital, AORN dei Colli, via Bianchi snc, Naples, Italy.
| | - Daniela Francisci
- Section of Infectious Diseases, Department of Medicine, University of Perugia, Piazzale Gambuli, 1, Perugia, Italy.
| | - Chiara Oltolini
- Department of Infectious Disease, San Raffaele Hospital, via Stamira d'Ancona, Milan, Italy.
| | - Giulia Palmiero
- First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, via Bianchi snc, Naples, Italy.
| | - Paolo Scarpellini
- Department of Infectious Disease, San Raffaele Hospital, via Stamira d'Ancona, Milan, Italy.
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Kang W, Sarkar S, Lin ZS, McKenney S, Konry T. Ultrafast Parallelized Microfluidic Platform for Antimicrobial Susceptibility Testing of Gram Positive and Negative Bacteria. Anal Chem 2019; 91:6242-6249. [DOI: 10.1021/acs.analchem.9b00939] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Wenjing Kang
- Department of Pharmaceutical Sciences, School of Pharmacy, Bouve College of Health Sciences, Northeastern University, 140 The Fenway, Boston, Massachusetts 02115, United States
| | - Saheli Sarkar
- Department of Pharmaceutical Sciences, School of Pharmacy, Bouve College of Health Sciences, Northeastern University, 140 The Fenway, Boston, Massachusetts 02115, United States
| | - Zhi Shen Lin
- Department of Pharmaceutical Sciences, School of Pharmacy, Bouve College of Health Sciences, Northeastern University, 140 The Fenway, Boston, Massachusetts 02115, United States
| | - Seamus McKenney
- Department of Pharmaceutical Sciences, School of Pharmacy, Bouve College of Health Sciences, Northeastern University, 140 The Fenway, Boston, Massachusetts 02115, United States
| | - Tania Konry
- Department of Pharmaceutical Sciences, School of Pharmacy, Bouve College of Health Sciences, Northeastern University, 140 The Fenway, Boston, Massachusetts 02115, United States
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Meiyazhagan G, Raju R, Winfred SB, Mannivanan B, Bhoopalan H, Shankar V, Sekar S, Venkatachalam DP, Pitani R, Nagendrababu V, Thaiman M, Devivanayagam K, Jayaraman J, Ragavachary R, Venkatraman G. Bioactivity Studies of β-Lactam Derived Polycyclic Fused Pyrroli-Dine/Pyrrolizidine Derivatives in Dentistry: In Vitro, In Vivo and In Silico Studies. PLoS One 2015; 10:e0131433. [PMID: 26185985 PMCID: PMC4505899 DOI: 10.1371/journal.pone.0131433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 06/02/2015] [Indexed: 11/22/2022] Open
Abstract
The antibacterial activity of β-lactam derived polycyclic fused pyrrolidine/pyrrolizidine derivatives synthesized by 1, 3-dipolar cycloaddition reaction was evaluated against microbes involved in dental infection. Fifteen compounds were screened; among them compound 3 showed efficient antibacterial activity in an ex vivo dentinal tubule model and in vivo mice infectious model. In silico docking studies showed greater affinity to penicillin binding protein. Cell damage was observed under Scanning Electron Microscopy (SEM) which was further proved by Confocal Laser Scanning Microscope (CLSM) and quantified using Flow Cytometry by PI up-take. Compound 3 treated E. faecalis showed ROS generation and loss of membrane integrity was quantified by flow cytometry. Compound 3 was also found to be active against resistant E. faecalis strains isolated from failed root canal treatment cases. Further, compound 3 was found to be hemocompatible, not cytotoxic to normal mammalian NIH 3T3 cells and non mutagenic. It was concluded that β-lactam compound 3 exhibited promising antibacterial activity against E. faecalis involved in root canal infections and the mechanism of action was deciphered. The results of this research can be further implicated in the development of potent antibacterial medicaments with applications in dentistry.
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Affiliation(s)
- Gowri Meiyazhagan
- Department of Human Genetics, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India
| | - Rajesh Raju
- Department of Organic Chemistry, University of Madras, Guindy Campus, Chennai, Tamilnadu, India
| | - Sofi Beaula Winfred
- Department of Human Genetics, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India
| | - Bhavani Mannivanan
- Department of Human Genetics, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India
| | - Hemadev Bhoopalan
- Department of Human Genetics, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India
| | - Venkatesh Shankar
- Department of Bioinformatics, Alagappa University, Karaikudi, Tamilnadu, India
| | - Sathiya Sekar
- Center for Toxicology and Developmental Research, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India
| | | | - Ravishankar Pitani
- Department of Community Medicine, Sri Ramachandra University, Porur, Chennai Tamilnadu, India
| | - Venkateshbabu Nagendrababu
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India
| | - Malini Thaiman
- Central Research Facility, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India
| | - Kandaswamy Devivanayagam
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India
| | | | - Raghunathan Ragavachary
- Department of Organic Chemistry, University of Madras, Guindy Campus, Chennai, Tamilnadu, India
- * E-mail: (RRag); (GV)
| | - Ganesh Venkatraman
- Department of Human Genetics, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India
- * E-mail: (RRag); (GV)
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Olawale AK, David OM, Oluyege AO, Osuntoyinbo RT, Laleye SA, Famurewa O. Histopathological changes induced in an animal model by potentially pathogenic Enterococcus faecalis strains recovered from ready-to-eat food outlets in Osun State, Nigeria. Infect Drug Resist 2015; 8:181-7. [PMID: 26170700 PMCID: PMC4492643 DOI: 10.2147/idr.s61381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Enterococci have been implicated as an emerging important cause of several diseases and multiple antibiotic resistance. However, there is little information about the prevalence of pathogenic and/or antibiotic-resistant Enterococcus faecalis in ready-to-eat foods in Nigeria. Here we report the pathogenic potential of three selected antibiotic-resistant E. faecalis strains isolated from food canteens and food outlets with different virulence determinant genes, including EFC 12 (with gel+, esp+, cylA+, and asa1+), EFT 148 (with gel+, ace+, and asa1+), and EFS 18 (with esp+ and cylA+) in an animal model. Enterococcemia, hematological parameters, and histopathological changes in organ tissues were examined in experimental animals. The results showed differences in enterococcemia and hematological parameters between the control group and experimental animal group. Enterococcemia was observed for 7 days, and the animal group infected with EFC 12 showed the highest growth rate, followed by EFT 148, with the lowest growth rate seen in the EFS 18-infected group. White blood cell count, packed cell volume, and platelets were significantly reduced (P<0.05) in the experimental animals compared with the controls. White blood cells decreased drastically during the study period in rats challenged with EFC 12 (from 7,800 to 6,120 per mm3) but levels remained higher in the control group (from 9,228 to 9,306 per mm3). Histopathological changes included areas of pronounced hemorrhage, necrosis, and distortion in liver tissues, which were more marked in rats infected with EFC 12, followed by EFT 148, then EFS 18. The results of this study suggest the presence of potentially pathogenic E. faecalis strains in food canteens and food outlets; hence, there is a need for strict adherence to good hygiene practices in the study area owing to the epidemiological significance of foods.
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Affiliation(s)
- Adetunji Kola Olawale
- Department of Applied Sciences, Osun State Polytechnic, Iree, Nigeria ; Department of Microbiology, University of Ado-Ekiti, Ado-Ekiti, Nigeria
| | - Oluwole Moses David
- Department of Microbiology, University of Ado-Ekiti, Ado-Ekiti, Nigeria ; Phytomedicine Research Centre, Department of Botany, University of Fort Hare, Alice, South Africa
| | | | | | | | - Oladiran Famurewa
- Department of Microbiology, University of Ado-Ekiti, Ado-Ekiti, Nigeria
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Michaux C, Saavedra LFR, Reffuveille F, Bernay B, Goux D, Hartke A, Verneuil N, Giard JC. Cold-shock RNA-binding protein CspR is also exposed to the surface of
Enterococcus faecalis. Microbiology (Reading) 2013; 159:2153-2161. [DOI: 10.1099/mic.0.071076-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Charlotte Michaux
- Unité de Recherche Risques Microbiens (U2RM), Equipe Stress Virulence Université de Caen Basse-Normandie, Caen, France
| | - Luis Felipe Romero Saavedra
- Unité de Recherche Risques Microbiens (U2RM), Equipe Stress Virulence Université de Caen Basse-Normandie, Caen, France
| | - Fany Reffuveille
- Plateforme Proteogen SFR ICORE 4206, Université de Caen Basse-Normandie, Caen, France
| | - Benoît Bernay
- Centre de Microscopie Appliquée à la Biologie, Université de Caen Basse-Normandie IFR ICORE, Caen, France
| | - Didier Goux
- Equipe Antibio-résistance, Université de Caen Basse-Normandie, Caen, France
| | - Axel Hartke
- Unité de Recherche Risques Microbiens (U2RM), Equipe Stress Virulence Université de Caen Basse-Normandie, Caen, France
| | - Nicolas Verneuil
- Unité de Recherche Risques Microbiens (U2RM), Equipe Stress Virulence Université de Caen Basse-Normandie, Caen, France
| | - Jean-Christophe Giard
- Centre for Microbial Diseases and Immunity Research, Department of Microbiology and Immunology, University of British Columbia, Vancouver, Canada
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Bassetti M, Merelli M, Temperoni C, Astilean A. New antibiotics for bad bugs: where are we? Ann Clin Microbiol Antimicrob 2013; 12:22. [PMID: 23984642 PMCID: PMC3846448 DOI: 10.1186/1476-0711-12-22] [Citation(s) in RCA: 264] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 08/25/2013] [Indexed: 01/05/2023] Open
Abstract
Bacterial resistance to antibiotics is growing up day by day in both community and hospital setting, with a significant impact on the mortality and morbidity rates and the financial burden that is associated. In the last two decades multi drug resistant microorganisms (both hospital- and community-acquired) challenged the scientific groups into developing new antimicrobial compounds that can provide safety in use according to the new regulation, good efficacy patterns, and low resistance profile. In this review we made an evaluation of present data regarding the new classes and the new molecules from already existing classes of antibiotics and the ongoing trends in antimicrobial development. Infectious Diseases Society of America (IDSA) supported a proGram, called “the ′10 × ´20′ initiative”, to develop ten new systemic antibacterial drugs within 2020. The microorganisms mainly involved in the resistance process, so called the ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa, and enterobacteriaceae) were the main targets. In the era of antimicrobial resistance the new antimicrobial agents like fifth generation cephalosporins, carbapenems, monobactams, β-lactamases inhibitors, aminoglycosides, quinolones, oxazolidones, glycopeptides, and tetracyclines active against Gram-positive pathogens, like vancomycin-resistant S. aureus (VRSA) and MRSA, penicillin-resistant streptococci, and vancomycin resistant Enterococcus (VRE) but also against highly resistant Gram-negative organisms are more than welcome. Of these compounds some are already approved by official agencies, some are still in study, but the need of new antibiotics still does not cover the increasing prevalence of antibiotic-resistant bacterial infections. Therefore the management of antimicrobial resistance should also include fostering coordinated actions by all stakeholders, creating policy guidance, support for surveillance and technical assistance.
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Affiliation(s)
- Matteo Bassetti
- Infectious Diseases Division, Santa Maria Misercordia Hospital, Udine, Italy.
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