2017 Global Surveillance of the in vitro activity of eravacycline against clinical isolates from GI infections
Author(s):
Kenneth Lawrence; Stephen Hawser; Nimmi Kothari; Federica Monti; Sophie Magnet; Corey Fyfe; Ian Morrissey
Background: Eravacycline is a fully-synthetic fluorocycline antibacterial of the tetracycline class that has recently received the Food and Drug Administration’s and European Commission’s approval for the treatment of complicated intra-abdominal infections (cIAI) in patients ≥18 years of age. It retains activity against the most common tetracycline-specific acquired resistance mechanisms (i.e., efflux and ribosomal protection). Eravacycline has shown activity against a broad range of Gram-negative, Gram-positive and anaerobic bacteria. In the present study, we report the in vitro activity of eravacycline and comparators against globally collected clinical isolates from gastrointestinal sources during 2017.
Hypothesis: From an ongoing multi-infection surveillance study, non-duplicate, non-consecutive, single-patient gastrointestinal isolates collected in 2017 from hospitals globally were analyzed.
Methods: From an ongoing multi-infection surveillance study, non-duplicate, non-consecutive, single-patient gastrointestinal isolates collected in 2017 from hospitals globally were analyzed. Minimum inhibitory concentrations (MICs) were determined by CLSI broth microdilution
Results:
| |
Eravacycline
|
Tigecycline
|
|
Group / Species (n)
|
MIC50
(µ/mL)
|
MIC90
(µ/mL)
|
MIN MIC
(µ/mL)
|
MAX MIC
(µ/mL)
|
MIC50
(µ/mL)
|
MIC90
(µ/mL)
|
MIN MIC
(µ/mL)
|
MAX MIC
(µ/mL)
|
|
Enterobacteriaceae (1028)
|
0.25
|
1.0
|
0.06
|
16.0
|
0.5
|
4.0
|
0.12
|
32.0
|
|
ESBL-producing (59)
|
0.25
|
1.0
|
0.06
|
4.0
|
0.5
|
4.0
|
0.12
|
16.0
|
|
E. coli (171)
|
0.12
|
0.25
|
0.06
|
1.0
|
0.25
|
0.5
|
0.12
|
4.0
|
|
C. freundii (121)
|
0.25
|
0.5
|
0.12
|
2.0
|
0.5
|
2.0
|
0.25
|
4.0
|
|
E. cloacae (171)
|
0.25
|
0.5
|
0.12
|
8.0
|
0.5
|
2.0
|
0.25
|
8.0
|
|
K. oxytoca (179)
|
0.12
|
0.25
|
0.06
|
16.0
|
0.5
|
1.0
|
0.12
|
32.0
|
|
K. pneumoniae (115)
|
0.25
|
1.0
|
0.12
|
8.0
|
0.5
|
2.0
|
0.25
|
8.0
|
Conclusions: Overall, eravacycline exhibited consistent and potent activity against the vast majority of Enterobacteriaceae isolates from a gastrointestinal source, including those that produced ESBL, with 2 to 4-fold greater activity than tigecycline. These data suggest eravacycline could play a role in the treatment of cIAI in patients who harbor or are at risk for infections due to resistant Enterobacteriaceae pathogens. Continued surveillance of the activity of eravacycline is merited