期刊
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
卷 56, 期 9, 页码 4779-4785出版社
AMER SOC MICROBIOLOGY
DOI: 10.1128/AAC.00817-12
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资金
- Cerexa, Inc. (Oakland, CA)
- Forest Laboratories, Inc. (New York, NY)
- Forest Research Institute, Inc.
- Achaogen
- Aires
- American Proficiency Institute (API)
- Anacor
- Astellas
- AstraZeneca
- Bayer
- bio-Merieux
- Cempra
- Cerexa
- Cosmo Technologies
- Contrafect
- Cubist
- Daiichi
- Dipexium
- Enanta
- Furiex
- GlaxoSmithKline
- Johnson & Johnson (Ortho McNeil)
- LegoChem Biosciences Inc.
- Meiji Seika Kaisha
- Merck
- Nabriva
- Novartis
- Paratek
- Pfizer (Wyeth)
- PPD Therapeutics
- Premier Research Group
- Rempex
- Rib-X Pharmaceuticals
- Seachaid
- Shionogi, Shionogi USA
- The Medicines Co.
- Theravance
- ThermoFisher
- TREK Diagnostics
- Vertex Pharmaceuticals
Ceftaroline is a new cephalosporin with broad-spectrum activity against Gram-positive and -negative organisms. The prodrug of ceftaroline, ceftaroline fosamil, combined with the beta-lactamase inhibitor avibactam (formerly NXL104), was tested against Enterobacteriaceae strains producing Ambler class A, B, C, and D enzymes, including strains producing multiple enzymes, as well as Pseudomonas aeruginosa, Acinetobacter spp., and methicillin-susceptible and methicillin-resistant Staphylococcus aureus (MRSA) strains. Isolates were collected from 1999 to 2008 from global surveillance programs, and susceptibility testing was performed by reference broth microdilution methods. Ceftaroline-avibactam exhibited potent activity against Enterobacteriaceae producing various beta-lactamase types (MIC90, 0.25 to 2 mu g/ml, except for metalloenzymes), including 99 strains carrying multiple enzymes (2 to 4 beta-lactamases; MIC90, 2 mu g/ml). All isolates were inhibited by ceftaroline-avibactam at <= 4 mu g/ml. Ceftaroline-avibactam (MIC90, 0.5 to 1 mu g/ml) was more active than meropenem (MIC90, >8 mu g/ml) and other comparators when tested against KPC-producing strains. S. aureus strains, including MRSA with four staphylococcal cassette chromosome mec (SCCmec) types, were dominantly (99.1%) inhibited by ceftaroline-avibactam at <= 2 mu g/ml, and the ceftaroline MIC was not adversely affected by the addition of the beta-lactamase inhibitor (MIC50/90, 1 and 2 mu g/ml for ceftaroline with and without avibactam). Ceftaroline-avibactam demonstrated limited activity against Acinetobacter spp. and P. aeruginosa (MIC(50)s, 32 and 16 mu g/ml, respectively). These results document that ceftaroline-avibactam has potent activity against Enterobacteriaceae that produce KPC, various ESBL types (CTX-M types), and AmpC (chromosomally derepressed or plasmid-mediated enzymes), as well as against those producing more than one of these beta-lactamase types, and its development as a therapeutic option for the treatment of infections caused by multidrug-resistant Enterobacteriaceae as well as MRSA is warranted.
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