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Efficacy of Omadacycline against Multidrug-Resistant Enterococcus faecium Strains in a Mouse Peritonitis Model. Antimicrob Agents Chemother 2021; 65:e0070921. [PMID: 34125596 DOI: 10.1128/aac.00709-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Omadacycline (OMC) showed better in vitro potency than daptomycin (DAP) or vancomycin (VAN) against Vanr, Ampr, DAP-nonsusceptible, linezolid-resistant, cfr(B)+ Enterococcus faecium strains. In a mouse peritonitis model, OMC also showed significantly better animal survival during the study and at its end than DAP or VAN with these E. faecium strains. However, OMC, DAP, and VAN showed comparable in vitro and in vivo efficacies against a non-vancomycin-resistant, tetracycline-resistant, DAP-susceptible E. faecium strain.
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2
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Xiong Y, Chen J, Sun X, Xu G, Li P, Deng Q, Yu Z, Chen Z, Zheng J. The Antibacterial and Antibiofilm Activity of Telithromycin Against Enterococcus spp. Isolated From Patients in China. Front Microbiol 2021; 11:616797. [PMID: 33519776 PMCID: PMC7841295 DOI: 10.3389/fmicb.2020.616797] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/14/2020] [Indexed: 01/02/2023] Open
Abstract
Telithromycin has been reported to possess robust in vitro antibacterial activity against many species of gram-positive bacteria, and telithromycin is also effective against Staphylococcus aureus biofilms. However, the in vitro antimicrobial susceptibility of telithromycin against clinical enterococci isolates in China is rarely reported and the impacts of telithromycin on the biofilm formation and eradication of enterococci remain elusive. Therefore, this study aimed to explore the inhibitory effects of telithromycin on planktonic cells and biofilms of Enterococcus strains. A total of 280 Enterococcus faecalis and 122 Enterococcus faecium isolates were collected from individual inpatients in China. The 50% minimum inhibitory concentration (MIC50) values of telithromycin against the E. faecalis and E. faecium strains carrying erythromycin-resistant methylase (erm) genes such as the ermA, ermB, or ermC, were 2 and 4 μg/mL, respectively. In addition, these isolates were typed using multilocus sequence typing (MLST) based on housekeeping genes. The predominant sequence types (STs) of E. faecalis were ST16, ST30, and ST179, and the main STs of E. faecium isolates were ST18, ST78, and ST80. Among these major STs, 87.1% (135/158) of E. faecalis and 80.4% (41/51) of E. faecium carried erm genes. Furthermore, at the subinhibitory concentrations (1/4 and 1/8 × MIC) of telithromycin, the biofilm formation of 16 E. faecalis isolates were inhibited by approximately 35%. Moreover, treatment with 8 × MIC of telithromycin or ampicillin led to an almost 40% reduction in the established biofilms of E. faecalis isolates, whereas vancomycin or linezolid with 8 × MIC had minimal effects. The combination of telithromycin and ampicillin resulted in an almost 70% reduction in the established biofilms of E. faecalis. In conclusion, these results revealed that telithromycin significantly decreased the planktonic cells of both E. faecalis and E. faecium. In addition, the data further demonstrated that telithromycin has the robust ability to inhibit E. faecalis biofilms and the combination of telithromycin and ampicillin improved antibiofilm activity. These in vitro antibacterial and antibiofilm activities suggest that telithromycin could be a potential candidate for the treatment of enterococcal infections.
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Affiliation(s)
- Yanpeng Xiong
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Shenzhen Nanshan People’s Hospital, Shenzhen University of School Medicine, Shenzhen, China
| | - Junwen Chen
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Shenzhen Nanshan People’s Hospital, Shenzhen University of School Medicine, Shenzhen, China
| | - Xiang Sun
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Shenzhen Nanshan People’s Hospital, Shenzhen University of School Medicine, Shenzhen, China
| | - Guangjian Xu
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Shenzhen Nanshan People’s Hospital, Shenzhen University of School Medicine, Shenzhen, China
| | - Peiyu Li
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Shenzhen Nanshan People’s Hospital, Shenzhen University of School Medicine, Shenzhen, China
| | - Qiwen Deng
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Shenzhen Nanshan People’s Hospital, Shenzhen University of School Medicine, Shenzhen, China
- Quality Control Center of Hospital Infection Management of Shenzhen, Shenzhen Nanshan People’s Hospital of Guangdong Medical University, Shenzhen, China
| | - Zhijian Yu
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Shenzhen Nanshan People’s Hospital, Shenzhen University of School Medicine, Shenzhen, China
- Quality Control Center of Hospital Infection Management of Shenzhen, Shenzhen Nanshan People’s Hospital of Guangdong Medical University, Shenzhen, China
| | - Zhong Chen
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Shenzhen Nanshan People’s Hospital, Shenzhen University of School Medicine, Shenzhen, China
- Quality Control Center of Hospital Infection Management of Shenzhen, Shenzhen Nanshan People’s Hospital of Guangdong Medical University, Shenzhen, China
| | - Jinxin Zheng
- Department of Infectious Diseases and Shenzhen Key Laboratory for Endogenous Infections, Shenzhen Nanshan People’s Hospital, Shenzhen University of School Medicine, Shenzhen, China
- Quality Control Center of Hospital Infection Management of Shenzhen, Shenzhen Nanshan People’s Hospital of Guangdong Medical University, Shenzhen, China
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3
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Rincon S, Panesso D, Miller WR, Singh KV, Cruz MR, Khan A, Dinh AQ, Diaz L, Rios R, Shamoo Y, Reyes J, Tran TT, Garsin DA, Arias CA. Disrupting Membrane Adaptation Restores In Vivo Efficacy of Antibiotics Against Multidrug-Resistant Enterococci and Potentiates Killing by Human Neutrophils. J Infect Dis 2020; 220:494-504. [PMID: 30938438 DOI: 10.1093/infdis/jiz131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/22/2019] [Indexed: 12/17/2022] Open
Abstract
Daptomycin resistance in enterococci is often mediated by the LiaFSR system, which orchestrates the cell membrane stress response. Activation of LiaFSR through the response regulator LiaR generates major changes in cell membrane function and architecture (membrane adaptive response), permitting the organism to survive the antibiotic attack. Here, using a laboratory strain of Enterococcus faecalis, we developed a novel Caenorhabditis elegans model of daptomycin therapy and showed that disrupting LiaR-mediated cell membrane adaptation restores the in vivo activity of daptomycin. The LiaR effect was also seen in a clinical strain of daptomycin-resistant Enterococcus faecium, using a murine model of peritonitis. Furthermore, alteration of the cell membrane response increased the ability of human polymorphonuclear neutrophils to readily clear both E. faecalis and multidrug-resistant E. faecium. Our results provide proof of concept that targeting the cell membrane adaptive response restores the in vivo activity of antibiotics, prevents resistance, and enhances the ability of the innate immune system to kill infecting bacteria.
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Affiliation(s)
- Sandra Rincon
- Center for Antimicrobial Resistance and Microbial Genomics, Rice University.,Molecular Genetics and Antimicrobial Resistance Unit and International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia
| | - Diana Panesso
- Center for Antimicrobial Resistance and Microbial Genomics, Rice University.,Department of Internal Medicine, Division of Infectious Diseases, Rice University.,Molecular Genetics and Antimicrobial Resistance Unit and International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia
| | - William R Miller
- Center for Antimicrobial Resistance and Microbial Genomics, Rice University.,Department of Internal Medicine, Division of Infectious Diseases, Rice University
| | - Kavindra V Singh
- Center for Antimicrobial Resistance and Microbial Genomics, Rice University.,Department of Internal Medicine, Division of Infectious Diseases, Rice University
| | - Melissa R Cruz
- Department of Microbiology and Molecular Genetics, UTHealth McGovern Medical School, Rice University
| | - Ayesha Khan
- Center for Antimicrobial Resistance and Microbial Genomics, Rice University.,Department of Microbiology and Molecular Genetics, UTHealth McGovern Medical School, Rice University
| | - An Q Dinh
- Center for Antimicrobial Resistance and Microbial Genomics, Rice University.,Department of Internal Medicine, Division of Infectious Diseases, Rice University
| | - Lorena Diaz
- Center for Antimicrobial Resistance and Microbial Genomics, Rice University.,Molecular Genetics and Antimicrobial Resistance Unit and International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia
| | - Rafael Rios
- Molecular Genetics and Antimicrobial Resistance Unit and International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia
| | | | - Jinnethe Reyes
- Center for Antimicrobial Resistance and Microbial Genomics, Rice University.,Molecular Genetics and Antimicrobial Resistance Unit and International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia
| | - Truc T Tran
- Center for Antimicrobial Resistance and Microbial Genomics, Rice University.,Department of Internal Medicine, Division of Infectious Diseases, Rice University
| | - Danielle A Garsin
- Center for Antimicrobial Resistance and Microbial Genomics, Rice University.,Department of Microbiology and Molecular Genetics, UTHealth McGovern Medical School, Rice University
| | - Cesar A Arias
- Center for Antimicrobial Resistance and Microbial Genomics, Rice University.,Department of Internal Medicine, Division of Infectious Diseases, Rice University.,Department of Microbiology and Molecular Genetics, UTHealth McGovern Medical School, Rice University.,Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center, Houston, Texas.,Molecular Genetics and Antimicrobial Resistance Unit and International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia
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4
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Efficacy of Tedizolid against Enterococci and Staphylococci, Including cfr + Strains, in a Mouse Peritonitis Model. Antimicrob Agents Chemother 2019; 63:AAC.02627-18. [PMID: 30670435 DOI: 10.1128/aac.02627-18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 01/14/2019] [Indexed: 12/11/2022] Open
Abstract
In a mouse peritonitis model, tedizolid was comparable to linezolid and daptomycin against an Enterococcus faecium strain (VANr, AMPr), an Enterococcus faecalis strain, and a methicillin-resistant Staphylococcus aureus (MRSA) strain with and without cfr Against a cfr(B)+ E. faecium, tedizolid was inferior in vivo to linezolid and daptomycin, despite an ∼4-fold lower MIC.
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Gelman D, Beyth S, Lerer V, Adler K, Poradosu-Cohen R, Coppenhagen-Glazer S, Hazan R. Combined bacteriophages and antibiotics as an efficient therapy against VRE Enterococcus faecalis in a mouse model. Res Microbiol 2018; 169:531-539. [PMID: 29777835 DOI: 10.1016/j.resmic.2018.04.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 04/06/2018] [Accepted: 04/17/2018] [Indexed: 10/16/2022]
Abstract
Clinical applications of bacteriophage therapy have been recently gathering significant attention worldwide, used mostly as rescue therapy in cases of near-fatal antibiotic failure. Thus, clinically relevant in-vivo models presenting both short- and long-term implications of phage therapy given as rescue treatment for fulminant infections are of highest importance. In this study, a cocktail consisting of two lytic bacteriophages was used to evaluate the therapeutic efficacy of phage therapy as a rescue treatment for severe septic peritonitis in a mouse model. We established that a single injection of the bacteriophage cocktail was sufficient to completely reverse a 100% mortality trend caused by Vancomycin-Resistant Enterococcus faecalis, with significant improvement in both the clinical state and laboratory test results, and without harmful effects on the microbiome. The combination of bacteriophages with a suboptimal antibiotic regimen imparts an additional beneficial effect on the treatment success.
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Affiliation(s)
- Daniel Gelman
- Institute of Dental Sciences, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Hadassah Campus, P.O.B 12272, Jerusalem, 91120, Israel; The Military Track of Medicine, Faculty of Medicine, The Hebrew University - Hadassah School of Medicine, Hadassah Campus, P.O.B 12272, Jerusalem, 91120, Israel.
| | - Shaul Beyth
- Orthopedic Surgery Department, Hadassah Medical Center, Hadassah University Hospital, P.O.B 12000, Jerusalem, 91120, Israel.
| | - Vanda Lerer
- Institute of Dental Sciences, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Hadassah Campus, P.O.B 12272, Jerusalem, 91120, Israel.
| | - Karen Adler
- Institute of Dental Sciences, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Hadassah Campus, P.O.B 12272, Jerusalem, 91120, Israel.
| | - Ronit Poradosu-Cohen
- Department of Infectious Diseases of Sourasky Medical Center and Tel-Aviv University, Tel-Aviv, Israel.
| | - Shunit Coppenhagen-Glazer
- Institute of Dental Sciences, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Hadassah Campus, P.O.B 12272, Jerusalem, 91120, Israel.
| | - Ronen Hazan
- Institute of Dental Sciences, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Hadassah Campus, P.O.B 12272, Jerusalem, 91120, Israel.
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Hall AE, Gorovits EL, Syribeys PJ, Domanski PJ, Ames BR, Chang CY, Vernachio JH, Patti JM, Hutchins JT. Monoclonal antibodies recognizing the Enterococcus faecalis collagen-binding MSCRAMM Ace: conditional expression and binding analysis. Microb Pathog 2007; 43:55-66. [PMID: 17521860 DOI: 10.1016/j.micpath.2007.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Revised: 03/23/2007] [Accepted: 03/25/2007] [Indexed: 10/23/2022]
Abstract
Enterococci are opportunistic pathogens known to cause numerous clinical infections and complications in humans. Adhesin-mediated binding to extracellular matrix (ECM) proteins of the host is thought to be a crucial step in the pathogenesis of these bacterial infections. Adhesin of collagen from Enterococcus faecalis (Ace) is a cell-wall anchored protein of E. faecalis that has been shown to be important for bacterial binding to the ECM. In this report, we characterize the conditions for Ace expression and demonstrate Ace binding to mammalian epithelial and endothelial cells as well as to collagens found in the ECM. To further characterize Ace expression and function, we report the generation of a panel of monoclonal antibodies (mAbs) directed against this important E. faecalis virulence factor. Through the use of multiple in vitro assays, surface plasmon resonance and flow cytometry, we have characterized this panel of mAbs which may prove to be not only beneficial in studies that address the precise biological role of adhesion of E. faecalis, but may also serve as beneficial therapeutic agents against E. faecalis infections.
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Affiliation(s)
- Andrea E Hall
- Inhibitex, Inc., 9005 Westside Parkway, Alpharetta, GA 30004, USA
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Pai SR, Singh KV, Murray BE. In vivo efficacy of the ketolide ABT-773 (cethromycin) against enterococci in a mouse peritonitis model. Antimicrob Agents Chemother 2003; 47:2706-9. [PMID: 12878548 PMCID: PMC166088 DOI: 10.1128/aac.47.8.2706-2709.2003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Using six Enterococcus faecalis and five Enterococcus faecium strains, the ketolide ABT-773 (ABT), now known as cethromycin, was found to have in vivo efficacy against both erythromycin (ERY)-susceptible (Ery(s)) and -intermediate (Ery(i)) enterococci (ABT 50% protective doses [PD(50)s], 0.5 to 4.1 and 10.3 to 16.2 mg/kg of body weight, respectively). Against four highly Ery-resistant (Ery(r)) strains for which ABT MICs were low, ABT showed much greater activity (PD(50), 6.3 to 32.5 mg/kg) than ERY (PD(50), >200 mg/kg) but was not protective for strains for which ABT MICs were high. In conclusion, ABT-773 showed in vivo efficacy and considerably greater activity than ERY in a mouse peritonitis model.
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Affiliation(s)
- Suresh R Pai
- Center for the Study of Emerging and Re-Emerging Pathogens, The University of Texas Medical School, Houston, Texas 77030, USA
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Nannini EC, Pai SR, Singh KV, Murray BE. Activity of tigecycline (GAR-936), a novel glycylcycline, against Enterococci in the mouse peritonitis model. Antimicrob Agents Chemother 2003; 47:529-32. [PMID: 12543654 PMCID: PMC151755 DOI: 10.1128/aac.47.2.529-532.2003] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A novel glycylcycline agent, tigecycline (GAR-936), was evaluated in vivo in the mouse model of peritonitis against three Enterococcus faecalis and four Enterococcus faecium isolates with different susceptibilities to vancomycin and tetracyclines, all of which were inhibited by </=0.125 micro g of tigecycline/ml. Using a single subcutaneous dose, tigecycline displayed a protective effect (50% protective dose, </=5.7 mg/kg of body weight) against all strains tested, including two with Tn925 (from the Tn916 family), which contains the Tet(M) tetracycline resistance determinant, as well as VanA and VanB strains. As expected, tetracycline and minocycline were ineffective against the isolates carrying Tn925.
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Affiliation(s)
- Esteban C Nannini
- Center for the Study of Emerging and Re-Emerging Pathogens, Division of Infectious Diseases, Department of Internal Medicine, The University of Texas Medical School, Houston, Texas, USA.
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Zhanel GG, Walters M, Noreddin A, Vercaigne LM, Wierzbowski A, Embil JM, Gin AS, Douthwaite S, Hoban DJ. The ketolides: a critical review. Drugs 2002; 62:1771-804. [PMID: 12149046 DOI: 10.2165/00003495-200262120-00006] [Citation(s) in RCA: 136] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Ketolides are a new class of macrolides designed particularly to combat respiratory tract pathogens that have acquired resistance to macrolides. The ketolides are semi-synthetic derivatives of the 14-membered macrolide erythromycin A, and retain the erythromycin macrolactone ring structure as well as the D-desosamine sugar attached at position 5. The defining characteristic of the ketolides is the removal of the neutral sugar, L-cladinose from the 3 position of the ring and the subsequent oxidation of the 3-hydroxyl to a 3-keto functional group. The ketolides presently under development additionally contain an 11, 12 cyclic carbamate linkage in place of the two hydroxyl groups of erythromycin A and an arylalkyl or an arylallyl chain, imparting in vitro activity equal to or better than the newer macrolides. Telithromycin is the first member of this new class to be approved for clinical use, while ABT-773 is presently in phase III of development. Ketolides have a mechanism of action very similar to erythromycin A from which they have been derived. They potently inhibit protein synthesis by interacting close to the peptidyl transferase site of the bacterial 50S ribosomal subunit. Ketolides bind to ribosomes with higher affinity than macrolides. The ketolides exhibit good activity against Gram-positive aerobes and some Gram-negative aerobes, and have excellent activity against drug-resistant Streptococcus pneumoniae, including macrolide-resistant (mefA and ermB strains of S. pneumoniae). Ketolides such as telithromycin display excellent pharmacokinetics allowing once daily dose administration and extensive tissue distribution relative to serum. Evidence suggests the ketolides are primarily metabolised in the liver and that elimination is by a combination of biliary, hepatic and urinary excretion. Pharmacodynamically, ketolides display an element of concentration dependent killing unlike macrolides which are considered time dependent killers. Clinical trial data are only available for telithromycin and have focused on respiratory infections including community-acquired pneumonia, acute exacerbations of chronic bronchitis, sinusitis and streptococcal pharyngitis. Bacteriological and clinical cure rates have been similar to comparators. Limited data suggest very good eradication of macrolide-resistant and penicillin-resistant S. pneumoniae. As a class, the macrolides are well tolerated and can be used safely. Limited clinical trial data suggest that ketolides have similar safety profiles to the newer macrolides. Telithromycin interacts with the cytochrome P450 enzyme system (specifically CYP 3A4) in a reversible fashion and limited clinically significant drug interactions occur. In summary, clinical trials support the clinical efficacy of the ketolides in upper and lower respiratory tract infections caused by typical and atypical pathogens including strains resistant to penicillins and macrolides. Considerations such as local epidemiology, patterns of resistance and ketolide adverse effects, drug interactions and cost relative to existing agents will define the role of these agents. The addition of the ketolides in the era of antibacterial resistance provides clinicians with more options in the treatment of respiratory infections.
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Affiliation(s)
- George G Zhanel
- Department of Medical Microbiology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
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