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Yamano Y, Ishibashi N, Kuroiwa M, Takemura M, Sheng WH, Hsueh PR. Characterisation of cefiderocol-non-susceptible Acinetobacter baumannii isolates from Taiwan. J Glob Antimicrob Resist 2022; 28:120-124. [PMID: 34958997 DOI: 10.1016/j.jgar.2021.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 12/02/2021] [Accepted: 12/20/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Cefiderocol (CFDC), a siderophore cephalosporin, is active against Gram-negative bacteria including carbapenem-resistant Acinetobacter baumannii (CRAB). In this study, 100 CRAB isolates from patients with bacteraemia in Taiwan were characterised, among which 21 CFDC-non-susceptible isolates were identified with a minimum inhibitory concentration (MIC) of ≥8 mg/L. METHODS The effect of avibactam on CFDC activity was evaluated using broth microdilution methods according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Whole-genome sequencing (WGS) was performed on all CFDC-non-susceptible isolates (MIC ≥ 8 mg/L) for multilocus sequence typing (MLST) analysis, possession of β-lactamase genes and identification of possible variations in the PiuA iron transporter. RESULTS Addition of avibactam, a diazabicyclooctane inhibitor for serine-type β-lactamases, resulted in a ≥8-fold decrease in the CFDC MIC for 15 of 21 CFDC-non-susceptible isolates compared with only 1 of 79 CFDC-susceptible isolates (MIC ≤ 4 mg/L). WGS analysis confirmed that all CFDC-non-susceptible isolates harboured multiple β-lactamases including ADC-30 homologues, OXA-23 and OXA-66. One isolate with a high MIC (>32 mg/L) had a PER-type extended-spectrum β-lactamase (ESBL) gene. Twenty other isolates belonged to ST455, ST473 and ST787. Among these, thirteen ST455 isolates were deficient in PiuA, a siderophore uptake receptor that may be required for optimal penetration of CFDC. CONCLUSION MICs of CFDC-non-susceptible CRAB isolates from Taiwan could be significantly decreased to susceptible levels by the addition of avibactam, suggesting the involvement of β-lactamases in resistance. Among the 21 CFDC-non-susceptible isolates, 1 isolate had a PER-type ESBL gene and 13 isolates lacked a PiuA iron siderophore transporter.
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Affiliation(s)
- Yoshinori Yamano
- Pharmaceutical Research Division, Shionogi & Co., Ltd., Osaka, Japan.
| | - Naoki Ishibashi
- Laboratory for Drug Discovery and Disease Research, Shionogi & Co., Ltd., Osaka, Japan
| | - Miho Kuroiwa
- Laboratory for Innovative Therapy Research, Shionogi & Co., Ltd., Osaka, Japan
| | - Miki Takemura
- Laboratory for Drug Discovery and Disease Research, Shionogi & Co., Ltd., Osaka, Japan
| | - Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Po-Ren Hsueh
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Departments of Laboratory Medicine and Internal Medicine, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan; PhD Program for Aging, College of Medicine, China Medical University, Taichung, Taiwan.
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Kohira N, Hackel MA, Ishioka Y, Kuroiwa M, Sahm DF, Sato T, Maki H, Yamano Y. Reduced susceptibility mechanism to cefiderocol, a siderophore cephalosporin, among clinical isolates from a global surveillance programme (SIDERO-WT-2014). J Glob Antimicrob Resist 2020; 22:738-741. [PMID: 32702396 DOI: 10.1016/j.jgar.2020.07.009] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/11/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To investigate possible mechanistic factors to explain cefiderocol (CFDC) non-susceptibility, we characterized 38 clinical isolates with a CFDC minimum inhibitory concentration (MIC) of >4μg/mL from a multi-national surveillance study. METHODS The MIC measurement in the presence of β-lactamase inhibitors and whole genome sequencing were performed. RESULTS The MIC decrease of CFDC by β-lactamase inhibitors was observed against all of the test isolates. Among the 38 isolates, NDM and PER genes were observed in 5 and 25 isolates, respectively. No other β-lactamases responsible for high MIC were identified in the other eight isolates. The MIC of CDFC against Escherichia coli isogenic strains introduced with NDM and PER β-lactamase increased by ≥16-fold, suggesting the contribution of NDM and PER to the non-susceptibility to CFDC. Against NDM producers, a ≥8-fold MIC increase was observed only when both serine- and metallo-type β-lactamase inhibitors were added. In addition, many of the PER or NDM producers remained susceptible to CFDC. These results suggested that the presence of only NDM or PER would not lead to non-susceptibility to CFDC and that multiple factors would be related to CFDC resistance. CONCLUSION Multiple factors including NDM and PER could be related to reduced susceptibility to CFDC.
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Affiliation(s)
- Naoki Kohira
- Laboratory for Drug Discovery and Disease Research, Shionogi & Co., Ltd., Osaka, Japan.
| | - Meredith A Hackel
- International Health Management Associates, Inc., Schaumburg, IL, USA
| | - Yoshino Ishioka
- Laboratory for Drug Discovery and Disease Research, Shionogi & Co., Ltd., Osaka, Japan
| | - Miho Kuroiwa
- Laboratory for Drug Discovery and Disease Research, Shionogi & Co., Ltd., Osaka, Japan
| | - Daniel F Sahm
- International Health Management Associates, Inc., Schaumburg, IL, USA
| | - Takafumi Sato
- Laboratory for Drug Discovery and Disease Research, Shionogi & Co., Ltd., Osaka, Japan
| | - Hideki Maki
- Laboratory for Drug Discovery and Disease Research, Shionogi & Co., Ltd., Osaka, Japan
| | - Yoshinori Yamano
- Laboratory for Drug Discovery and Disease Research, Shionogi & Co., Ltd., Osaka, Japan
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Aoki T, Yoshizawa H, Yamawaki K, Yokoo K, Sato J, Hisakawa S, Hasegawa Y, Kusano H, Sano M, Sugimoto H, Nishitani Y, Sato T, Tsuji M, Nakamura R, Nishikawa T, Yamano Y. Cefiderocol (S-649266), A new siderophore cephalosporin exhibiting potent activities against Pseudomonas aeruginosa and other gram-negative pathogens including multi-drug resistant bacteria: Structure activity relationship. Eur J Med Chem 2018; 155:847-868. [PMID: 29960205 DOI: 10.1016/j.ejmech.2018.06.014] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/21/2018] [Accepted: 06/04/2018] [Indexed: 12/21/2022]
Abstract
The structure-activity relationship (SAR) for a novel series of catechol conjugated siderophore cephalosporins is described with their in vitro activities against multi-drug resistant Gram-negative pathogens including Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia and Enterobacteriaceae. Cefiderocol (3) was one of the best molecules which displayed well-balanced and potent activities against multi-drug resistant Gram-negative pathogens including carbapenem resistant bacteria among the prepared compounds with the modified C-7 side chain and the modified C-3 side chain. Cefiderocol (3) is a highly promising parenteral cephalosporin for the treatment of multi-drug resistant Gram-negative infection.
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Affiliation(s)
- Toshiaki Aoki
- Medicinal Chemistry Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan.
| | - Hidenori Yoshizawa
- Medicinal Chemistry Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Kenji Yamawaki
- Medicinal Chemistry Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Katsuki Yokoo
- Medicinal Chemistry Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Jun Sato
- Medicinal Chemistry Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Shinya Hisakawa
- Medicinal Chemistry Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Yasushi Hasegawa
- Medicinal Chemistry Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Hiroki Kusano
- Medicinal Chemistry Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Masayuki Sano
- Medicinal Chemistry Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Hideki Sugimoto
- Medicinal Chemistry Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Yasuhiro Nishitani
- Medicinal Chemistry Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Takafumi Sato
- Drug Discovery & Disease Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Masakatsu Tsuji
- Drug Discovery & Disease Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Rio Nakamura
- Drug Discovery & Disease Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Toru Nishikawa
- Drug Discovery & Disease Research Laboratory, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
| | - Yoshinori Yamano
- Pharmaceutical Research Division, Shionogi & Co., Ltd., 1-1, Futabacho, 3-chome, Toyonaka, 561-0825, Osaka, Japan
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Katsube T, Miyazaki S, Narukawa Y, Hernandez-Illas M, Wajima T. Drug-drug interaction of cefiderocol, a siderophore cephalosporin, via human drug transporters. Eur J Clin Pharmacol 2018; 74:931-938. [PMID: 29627897 DOI: 10.1007/s00228-018-2458-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 03/27/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE Cefiderocol, a siderophore cephalosporin, will be used concomitantly with other medications for treatment of bacterial infections. In vitro studies demonstrated inhibition potential of cefiderocol on organic anion transporter (OAT) 1, OAT3, organic cation transporter (OCT) 1, OCT2, multidrug and toxin extrusion (MATE) 2-K, and organic anion transporting polypeptide (OATP) 1B3. The aim of this study was to assess in vivo drug-drug interaction (DDI) potential of cefiderocol using probe substrates for these transporters. METHODS DDI potentials of cefiderocol as inhibitors were assessed in a clinical study consisting of 3 cohorts. Twelve or 13 healthy adult subjects per cohort orally received a single dose of furosemide 20 mg (for OAT1/3), metformin 1000 mg (for OCT1/2 and MATE2-K), or rosuvastatin 10 mg (for OATP1B3) with or without co-administration with cefiderocol 2 g every 8 h with 3-h infusion (a total of 3, 6, and 9 doses of cefiderocol with furosemide, metformin, and rosuvastatin, respectively). DDI potentials were assessed based on the pharmacokinetics of the substrates. RESULTS Ratios (90% confidence intervals) of maximum plasma concentration and area under the plasma concentration-time curve were 1.00 (0.71-1.42) and 0.92 (0.73-1.16) for furosemide, 1.09 (0.92-1.28) and 1.03 (0.93-1.15) for metformin, and 1.28 (1.12-1.46) and 1.21 (1.08-1.35) for rosuvastatin, respectively. Exposures to furosemide or metformin did not change when co-administered with cefiderocol. Slight increase in rosuvastatin exposure was observed with co-administered with cefiderocol, which was not considered to be clinically significant. Each treatment was well tolerated. CONCLUSIONS Cefiderocol has no clinically significant DDI potential via drug transporters.
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Affiliation(s)
- Takayuki Katsube
- Clinical Pharmacology & Pharmacokinetics, Shionogi & Co., Ltd., Osaka, Japan.
| | - Shiro Miyazaki
- Drug Metabolism & Pharmacokinetics Department, Shionogi & Co., Ltd., Toyonaka, Osaka, Japan
| | | | | | - Toshihiro Wajima
- Clinical Pharmacology & Pharmacokinetics, Shionogi & Co., Ltd., Osaka, Japan
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Huband MD, Ito A, Tsuji M, Sader HS, Fedler KA, Flamm RK. Cefiderocol MIC quality control ranges in iron-depleted cation-adjusted Mueller-Hinton broth using a CLSI M23-A4 multi-laboratory study design. Diagn Microbiol Infect Dis 2017; 88:198-200. [PMID: 28410852 DOI: 10.1016/j.diagmicrobio.2017.03.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/14/2017] [Accepted: 03/17/2017] [Indexed: 12/17/2022]
Abstract
Cefiderocol (formerly S-649266) is a new catechol-substituted parenteral siderophore cephalosporin with potent in vitro antibacterial activity against Gram-negative isolates including multidrug-resistant strains. A recent study following CLSI M23-A4 quality control guidelines established cefiderocol MIC QC ranges against Escherichia coli ATCC 25922 (0.06-0.5 μg/mL) and Pseudomonas aeruginosa ATCC 27853 (0.06-0.5 μg/mL).
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Affiliation(s)
| | - Akinobu Ito
- Drug Discovery & Disease Research Laboratory, Shionogi & Co., Ltd., Toyonaka, Osaka, Japan
| | - Masakatsu Tsuji
- Drug Discovery & Disease Research Laboratory, Shionogi & Co., Ltd., Toyonaka, Osaka, Japan
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