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Related Experiment Videos

Alternative drugs against multiresistant Gram-negative bacteria.

Lauro Vieira Perdigão Neto1, Maura Salaroli Oliveira2, Tatiana D'Annibale Orsi3

  • 1Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo, Rua Dr Ovídio Pires de Campos 225, Sala 629, São Paulo, SP 05403-010, Brazil; Department of Infectious Diseases and LIM-49, Universidade de Sao Paulo, Av. Dr Enéas de Carvalho Aguiar 470, São Paulo, SP 05403-000, Brazil.

Journal of Global Antimicrobial Resistance
|August 22, 2020
PubMed
Summary

Multidrug-resistant Gram-negative bacteria pose a global threat. This study found high susceptibility to tigecycline, minocycline, ceftazidime/avibactam, and fosfomycin in various resistant bacterial strains.

Keywords:
Alternative antimicrobialsCarbapenem resistanceGram-negativeMultiresistancePolymyxin resistanceWhole-genome sequencing

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Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Multidrug-resistant (MDR) Gram-negative bacteria, including Enterobacterales and non-fermenters, present a significant global health challenge.
  • The increasing prevalence of pan-resistant strains and the diminishing pipeline of effective antimicrobial therapies necessitate the evaluation of older and less-utilized drugs.

Purpose of the Study:

  • To assess the antimicrobial susceptibility of 50 genetically distinct, highly resistant Gram-negative bacterial isolates against a panel of older and less-common antimicrobial agents.
  • To identify the antimicrobial resistance genes present in these challenging bacterial pathogens.

Main Methods:

  • Antimicrobial susceptibility testing was performed on 50 MDR Gram-negative bacterial isolates.
  • Whole-genome sequencing was employed to determine bacterial lineages and characterize antimicrobial resistance genes.

Main Results:

  • High susceptibility rates were observed for tigecycline (96% across species, excluding P. aeruginosa), minocycline (100% in A. baumannii), doxycycline (93% in A. baumannii), ceftazidime/avibactam (100% in S. marcescens, 96% in K. pneumoniae), and fosfomycin (88% in S. marcescens).
  • Carbapenemase genes (blaKPC-2, blaOXA-23) and aminoglycoside-modifying enzyme genes were prevalent (56% and 22%, respectively).
  • Chloramphenicol and quinolones showed low susceptibility rates (6% each).

Conclusions:

  • Tigecycline demonstrated promising activity against most tested Gram-negative bacteria, except P. aeruginosa.
  • Minocycline, ceftazidime/avibactam, and fosfomycin showed significant efficacy against specific Gram-negative pathogens like A. baumannii, Enterobacterales, and S. marcescens, respectively.