scholarly journals Is there a role for tedizolid in the treatment of non-tuberculous mycobacterial disease?

2019 ◽  
Vol 75 (3) ◽  
pp. 609-617 ◽  
Author(s):  
Mike Marvin Ruth ◽  
Valerie A C M Koeken ◽  
Lian J Pennings ◽  
Elin M Svensson ◽  
Heiman F L Wertheim ◽  
...  
Keyword(s):  
Bacterial Population ◽  
Mycobacterium Abscessus ◽  
Multidrug Therapy ◽  
Pulmonary Infections ◽  
Mycobacterial Disease ◽  
Bacteriostatic Effect ◽  
Dependent Activity ◽  
Cure Rates ◽  
Time Kill ◽  
Over Time

Abstract Background Pulmonary infections caused by non-tuberculous mycobacteria (NTM) are hard to treat and have low cure rates despite intensive multidrug therapy. Objectives To assess the feasibility of tedizolid, a new oxazolidinone, for the treatment of Mycobacterium avium and Mycobacterium abscessus. Methods We determined MICs of tedizolid for 113 isolates of NTM. Synergy with key antimycobacterial drugs was assessed using the chequerboard method and calculation of the FIC index (FICI). We performed time–kill kinetics assays of tedizolid alone and combined with amikacin for M. abscessus and with ethambutol for M. avium. Human macrophages were infected with M. abscessus and M. avium and subsequently treated with tedizolid; intracellular and extracellular cfu were quantified over time. Results NTM isolates generally had a lower MIC of tedizolid than of linezolid. FICIs were lowest between tedizolid and amikacin for M. abscessus (FICI = 0.75) and between tedizolid and ethambutol for M. avium (FICI = 0.72). Clarithromycin and tedizolid showed initial synergy, which was abrogated by erm(41)-induced macrolide resistance (FICI = 0.53). Tedizolid had a weak bacteriostatic effect on M. abscessus and combination with amikacin slightly prolonged its effect. Tedizolid had concentration-dependent activity against M. avium and its efficacy was enhanced by ethambutol. Both combinations had a concentration-dependent synergistic effect. Tedizolid could inhibit the intracellular bacterial population of both M. avium and M. abscessus. Conclusions Tedizolid should be further investigated in pharmacodynamic studies and clinical trials for M. avium complex pulmonary disease. It is less active against M. abscessus, but still promising.

scholarly journals Mycobacterium abscessus complex: A Review of Recent Developments in an Emerging Pathogen

2021 ◽  
Vol 11 ◽  
Author(s):  
Laura Victoria ◽  
Amolika Gupta ◽  
Jose Luis Gómez ◽  
Jaime Robledo
Keyword(s):  
Molecular Mechanisms ◽  
Mycobacterium Abscessus ◽  
Molecular Techniques ◽  
Pulmonary Infections ◽  
Chronic Lung Diseases ◽  
Mycobacterium Abscessus Complex ◽  
Recent Developments ◽  
Cure Rates ◽  
Patients Experience ◽  
Multiple Relapses

Mycobacterium abscessus complex (MABC) is one of the most clinically relevant species among nontuberculous mycobacteria. MABC’s prevalence has increased over the last two decades. Although these changes can be explained by improvements in microbiological and molecular techniques for identifying species and subspecies, a higher prevalence of chronic lung diseases may contribute to higher rates of MABC. High rates of antimicrobial resistance are seen in MABC, and patients experience multiple relapses with low cure rates. This review aims to integrate existing knowledge about MABC epidemiology, microbiological identification and familiarize readers with molecular mechanisms of resistance and therapeutic options for pulmonary infections with MABC.

scholarly journals Impact of relebactam-mediated inhibition of Mycobacterium abscessus BlaMab β-lactamase on the in vitro and intracellular efficacy of imipenem

2019 ◽  
Author(s):  
Eva Le Run ◽  
Heiner Atze ◽  
Michel Arthur ◽  
Jean-Luc Mainardi
Keyword(s):  
Second Generation ◽  
Antibacterial Activities ◽  
Mycobacterium Abscessus ◽  
Pulmonary Infections ◽  
Human Macrophages ◽  
Time Kill ◽  
The Impact ◽  
Intracellular Proliferation ◽  
Lactamase Inhibitor

Abstract Objectives Imipenem is one of the recommended β-lactams for the treatment of Mycobacterium abscessus pulmonary infections in spite of the production of BlaMab β-lactamase. Avibactam, a second-generation β-lactamase inhibitor, was previously shown to inactivate BlaMab, but its partner drug, ceftazidime, is devoid of any antibacterial activity against M. abscessus. Here, we investigate whether relebactam, a novel second-generation inhibitor developed in combination with imipenem, improves the activity of this carbapenem against M. abscessus. Methods The impact of BlaMab inhibition by relebactam was evaluated by determining MICs, time–kill curves and M. abscessus intracellular proliferation in human macrophages. Kinetic parameters for the inhibition of BlaMab by relebactam were determined by spectrophotometry using nitrocefin as the substrate. The data were compared with those obtained with avibactam. Results Combination of relebactam (4 mg/L) with β-lactams led to >128- and 2-fold decreases in the MICs of amoxicillin (from >4096 to 32 mg/L) and imipenem (from 8 to 4 mg/L). In vitro, M. abscessus was not killed by the imipenem/relebactam combination. In contrast, relebactam increased the intracellular activity of imipenem, leading to 88% killing. Relebactam and avibactam similarly potentiated the antibacterial activities of β-lactams although BlaMab was inactivated 150-fold less effectively by relebactam than by avibactam. Conclusions Inhibition of BlaMab by relebactam improves the efficacy of imipenem against M. abscessus in macrophages, indicating that the imipenem/relebactam combination should be clinically considered for the treatment of infections due to M. abscessus.

scholarly journals RNA-sequencing elucidates drug-specific mechanisms of antibiotic tolerance and resistance in M. abscessus

2021 ◽  
Author(s):  
Jodie A. Schildkraut ◽  
Jordy P.M. Coolen ◽  
Sophie Burbaud ◽  
Jasper J.N. Sangen ◽  
Michael P Kwint ◽  
...  
Keyword(s):  
Rna Sequencing ◽  
Sigma Factor ◽  
Opportunistic Pathogen ◽  
Mycobacterium Abscessus ◽  
Strain Specificity ◽  
Cytochrome Bd ◽  
Transcriptomic Responses ◽  
Cure Rates ◽  
Time Kill ◽  
Current Guidelines

Mycobacterium abscessus is an opportunistic pathogen notorious for its resistance to most classes of antibiotics and low cure rates. M. abscessus carries an array of mostly unexplored defence mechanisms. A deeper understanding of antibiotic resistance and tolerance mechanisms is pivotal in development of targeted therapeutic regimens. We provide the first description of all major transcriptional mechanisms of tolerance to all antibiotics recommended in current guidelines, using RNA sequencing-guided experiments. M. abscessus ATCC 19977 bacteria were subjected to sub-inhibitory concentrations of clarithromycin, amikacin, tigecycline, cefoxitin and clofazimine for 4- and 24-hours, followed by RNA sequencing. To confirm key mechanisms of tolerance suggested by transcriptomic responses, we performed time-kill kinetic analysis using bacteria after pre-exposure to clarithromycin, amikacin or tigecycline for 24-hours and we constructed isogenic knockout and knockdown strains. To assess strain specificity, pan-genome analysis of 35 strains from all three subspecies was performed. Mycobacterium abscessus shows both drug-specific and common transcriptomic responses to antibiotic exposure. Ribosome-targeting antibiotics clarithromycin, amikacin and tigecycline elicit a common response characterized by upregulation of ribosome structural genes, the WhiB7 regulon and transferases, accompanied by downregulation of respiration through NuoA-N. Exposure to any of these drugs decreases susceptibility to ribosome-targeting drugs from multiple classes. The cytochrome bd-type quinol oxidase contributes to clofazimine tolerance in M. abscessus and the sigma factor sigH but not anti-sigma factor MAB_3542c is involved in tigecycline resistance. The observed transcriptomic responses are not strain-specific, as all genes involved in tolerance, except erm(41), are found in all included strains.

scholarly journals In vitro and intracellular activity of imipenem combined with tedizolid, rifabutin, and avibactam against Mycobacterium abscessus

2018 ◽  
Author(s):  
Eva Le Run ◽  
Michel Arthur ◽  
Jean-Luc Mainardi
Keyword(s):  
Inhibitory Concentration ◽  
Antibacterial Activities ◽  
Mycobacterium Abscessus ◽  
Pulmonary Infections ◽  
Once Daily ◽  
Minimal Inhibitory Concentrations ◽  
Recommended Treatment ◽  
The Impact ◽  
Lactamase Inhibitor

Mycobacterium abscessus has emerged as a significant pathogen responsible for chronic pulmonary infections in cystic fibrosis (CF) patients, which are difficult to treat due to resistance to a broad range of antibiotics. The initial phase of the recommended treatment in CF patients includes imipenem used without any β-lactamase inhibitor in spite of the production of the β-lactamase BlaMab. Here, we determine whether the addition of tedizolid, a once-daily oxazolidinone, improves the activity of imipenem alone or in combination with a β-lactamase inhibitor, avibactam, and rifabutin.The activity of the drugs was evaluated against M. abscessus CIP104536 by determining in vitro and intracellular antibacterial activities. The impact of BlaMab inhibition by avibactam on antibiotic activity was assessed by comparing CIP104536 and its β-lactamase-deficient derivative (ΔblaMab).The minimal inhibitory concentrations (MICs) of tedizolid against M. abscessus CIP104536 and ΔblaMab were 4 μg/mL. Tedizolid combined with imipenem showed a moderate synergistic effect with fractional inhibitory concentration (FIC) indexes of 0.41 and 0.38 for CIP104536 and ΔblaMab, respectively. For both strains, the addition of tedizolid at 2 μg/mL, corresponding to the peak serum concentration, increased the intracellular efficacy of imipenem at 8 and 32 μg/mL. Addition of avibactam and rifabutin improved the activity of the imipenem-tedizolid combination against CIP104536S.The imipenem-tedizolid combination should be further considered for the treatment of M. abscessus pulmonary infections in CF patients. The efficacy of the treatment might benefit from the use of a β-lactamase inhibitor, such as avibactam, and the addition of rifabutin.

scholarly journals Essential oils as potential anti-staphylococcal agents

2018 ◽  
Vol 68 (1) ◽  
pp. 95-107 ◽  
Author(s):  
Szweda Piotr ◽  
Zalewska Magdalena ◽  
Pilch Joanna ◽  
Kot Barbara ◽  
Milewski Sławomir
Keyword(s):  
Antimicrobial Activity ◽  
Essential Oils ◽  
Bovine Mastitis ◽  
Bactericidal Effect ◽  
Dilution Method ◽  
Kinetic Assay ◽  
Cinnamon Oil ◽  
Microtiter Plates ◽  
Cure Rates ◽  
Time Kill

Abstract Antibiotic therapy of staphylococcal mastitis is characterized by significantly lower cure rates compared to infections caused by other microorganisms. Thus, it is necessary to search for new, alternative, non-antibiotic agents that are effective in the eradication of these bacteria. The aim of our research was to investigate the antimicrobial, especially anti-staphylococcal potential of a large collection (n=36) of essential oils (EOs). Investigation of the antimicrobial activity of tested oils was determined by using a serial, twofold dilution method in 96-wells microtiter plates under conditions recommended by the Clinical and Laboratory Standards Institute (CLSI). The preliminary analysis revealed that six oils, namely: Manuka, Thyme, Geranium, Cedar, Cinnamon (from bark) and Patchouli exhibited the highest activity against reference strains of bacteria. Significant anti-staphylococcal potential of these oils has been also confirmed for a group of 18 Staphylococcus aureus, 8 Staphylococcus epidermidis and 5 Staphylococcus xylosus strains isolated from cases of bovine mastitis. Especially high activity was observed for Cedar, Patchouli, Thyme and Manuka oils. The MIC (Minimal Inhibitory Concentration) values for Patchouli oil were in the concentrations range of 0.01 to 0.313% (v/v). The three other oils inhibited the growth of staphylococci isolated from mastitis in the concentrations range of 0.01 to 0.625% (v/v). Oils isolated from Cinnamomum cassia and Pelargonium graveolens revealed a bit lower, but still satisfactory activity (MIC values in the concentrations range of 0.02 to 1.25% (v/v) and from 0.078 to 1.25% (v/v), respectively). In many cases a slightly higher concentration of oils was required to obtain the bactericidal effect in comparison to growth inhibition. The time – kill kinetic assay revealed that the bactericidal effect was achieved after two hours incubation of the reference strain S. aureus PCM 2051 cells with Thyme oil at concentration equal to 2xMIC (1.25% (v/v)) or MIC (0.625% (v/v)). A slightly lower activity was observed in the case of Cinnamon oil, the bactericidal effect was achieved after 8 hours of incubation. The results of our research clearly indicate that some essential oils exhibit a promising antimicrobial activity and can be considered as alternative antistaphylococcal agents.

scholarly journals Select β-Lactam Combinations Exhibit Synergy againstMycobacterium abscessus In Vitro

2019 ◽  
Vol 63 (4) ◽  
Author(s):  
Elizabeth Story-Roller ◽  
Emily C. Maggioncalda ◽  
Gyanu Lamichhane
Keyword(s):  
Treatment Options ◽  
Unmet Need ◽  
Mycobacterium Abscessus ◽  
Nontuberculous Mycobacterium ◽  
Pulmonary Infections ◽  
Content Type ◽  
Resistant Mutants ◽  
Lactamase Inhibitor ◽  
Selection Of

ABSTRACTMycobacterium abscessusis a nontuberculous mycobacterium that causes invasive pulmonary infections in patients with structural lung disease.M. abscessusis intrinsically resistant to several classes of antibiotics, and an increasing number of strains isolated from patients exhibit resistance to most antibiotics considered for treatment of infections by this mycobacterium. Therefore, there is an unmet need for new regimens with improved efficacy to treat this disease. Synthesis of the essential cell wall peptidoglycan inM. abscessusis achieved via two enzyme classes,l,d- andd,d-transpeptidases, with each class preferentially inhibited by different subclasses of β-lactam antibiotics. We hypothesized that a combination of two β-lactams that comprehensively inhibit the two enzyme classes will exhibit synergy in killingM. abscessus. Paired combinations of antibiotics tested forin vitrosynergy againstM. abscessusincluded dual β-lactams, a β-lactam and a β-lactamase inhibitor, and a β-lactam and a rifamycin. Of the initial 206 combinations screened, 24 pairs exhibited synergy. A total of 13/24 pairs were combinations of two β-lactams, and 12/24 pairs brought the MICs of both drugs to within the therapeutic range. Additionally, synergistic drug pairs significantly reduced the frequency of selection of spontaneous resistant mutants. These novel combinations of currently available antibiotics may offer viable immediate treatment options against highly-resistantM. abscessusinfections.

scholarly journals Rifabutin Acts in Synergy and Is Bactericidal with FrontlineMycobacterium abscessusAntibiotics Clarithromycin and Tigecycline, Suggesting a Potent Treatment Combination

2018 ◽  
Vol 62 (8) ◽  
Author(s):  
Mark Pryjma ◽  
Ján Burian ◽  
Charles J. Thompson
Keyword(s):  
Treatment Options ◽  
Multidrug Resistant ◽  
Current Treatment ◽  
Mycobacterium Abscessus ◽  
Triple Combination ◽  
Pulmonary Infections ◽  
Treatment Combination ◽  
Content Type ◽  
Current Treatment Regimen ◽  
Drug Regimens

ABSTRACTMycobacterium abscessusis a rapidly emerging mycobacterial pathogen causing dangerous pulmonary infections. Because these bacteria are intrinsically multidrug resistant, treatment options are limited and have questionable efficacy. The current treatment regimen relies on a combination of antibiotics, including clarithromycin paired with amikacin and either imipenem or cefoxitin. Tigecycline may be added when triple therapy is ineffective. We initially screened a library containing the majority of clinically available antibiotics for anti-M. abscessusactivity. The screen identified rifabutin, which was then investigated for its interactions withM. abscessusantibiotics used in drug regimens. Combination of rifabutin with either clarithromycin or tigecycline generated synergistic anti-M. abscessusactivity, dropping the rifabutin MIC below concentrations found in the lung. Importantly, these combinations generated bactericidal activity. The triple combination of clarithromycin, tigecycline, and rifabutin was also synergistic, and clinically relevant concentrations had a sterilizing effect onM. abscessuscultures. We suggest that combinations including rifabutin should be further investigated for treatment ofM. abscessuspulmonary infections.

scholarly journals Holdover Inoculum of Pseudomonas syringae pv. alisalensis from Broccoli Raab Causes Disease in Subsequent Plantings

Plant Disease ◽  
2006 ◽  
Vol 90 (8) ◽  
pp. 1077-1084 ◽  
Author(s):  
N. A. Cintas ◽  
S. T. Koike ◽  
R. A. Bunch ◽  
C. T. Bull
Keyword(s):  
Pseudomonas Syringae ◽  
Brassica Rapa ◽  
Bacterial Blight ◽  
Laboratory Tests ◽  
Bacterial Population ◽  
Disease Incidence ◽  
Untreated Soil ◽  
Bacterial Populations ◽  
Field Soils ◽  
Over Time

Uniform plots of broccoli raab (Brassica rapa subsp. rapa) seedlings were inoculated with a rifampicin-resistant strain of Pseudomonas syringae pv. alisalensis, the causal agent of bacterial blight on crucifers, resulting in 100% disease incidence in mature plants. Diseased plants were incorporated into the soil at maturity and smaller replicated plots were replanted at various times after incorporation. Rifampicin-resistant fluorescent pseudomonads with rep-PCR profiles identical to P. syringae pv. alisalensis were isolated from lesions on plants grown in soil into which the first diseased crop was incorporated. Disease incidence declined in mature plants as the length of time between incorporation of the first planting and seeding of the replanted plots increased. Bacterial population levels in soil decreased over time and bacteria were no longer detectable 3 weeks after incorporation of the diseased crop. In laboratory tests, population levels of P. syringae pv. alisalensis decreased in untreated soil but not in autoclaved soil. Greenhouse studies demonstrated a direct correlation between population levels of P. syringae pv. alisalensis applied to soil and disease incidence in seedlings. However, the decline in bacterial populations in field soils did not wholly account for the decline in disease incidence with subsequent plantings.

scholarly journals Increased Killing of Staphylococci and Streptococci by Daptomycin Compared with Cefazolin and Vancomycin in an In Vitro Peritoneal Dialysate Model

2003 ◽  
Vol 47 (12) ◽  
pp. 3764-3767 ◽  
Author(s):  
Elizabeth D. Hermsen ◽  
Laurie B. Hovde ◽  
John R. Hotchkiss ◽  
John C. Rotschafer
Keyword(s):  
Antibacterial Activity ◽  
Staphylococcus Epidermidis ◽  
Bacteriostatic Effect ◽  
Peritoneal Dialysate ◽  
Streptococcus Sanguis ◽  
Promising Agent ◽  
Mueller Hinton ◽  
Dependent Activity ◽  
Mueller Hinton Broth

ABSTRACT Peritoneal dialysate fluid (PDF) is a bacteriostatic medium that compromises the antibacterial activity of cell wall-active agents. By use of an in vitro static model, methicillin-resistant Staphylococcus aureus (MRSA), methicillin-susceptible S. aureus (MSSA), methicillin-susceptible Staphylococcus epidermidis (MSSE), and Streptococcus sanguis were exposed to daptomycin at concentrations of 10, 30, and 100 mg/liter, cefazolin at 125 mg/liter, and vancomycin at 25 mg/liter in cation-adjusted Mueller-Hinton Broth or Todd Hewitt Broth (for S. sanguis) and PDF at pHs of 5.5 and 7.4. The pH had no effect on antibacterial activity. Neither cefazolin nor vancomycin produced a bactericidal or a bacteriostatic effect versus MRSA, MSSA, MSSE, or S. sanguis in PDF, while all concentrations of daptomycin were bactericidal against all organisms in PDF. Daptomycin did not exhibit concentration-dependent activity in PDF. Daptomycin appears to be a promising agent for use in peritoneal dialysis-associated peritonitis, producing bacterial kill to a greater extent and at a higher rate than cefazolin or vancomycin in PDF.

scholarly journals Differential in vitro activity of individual drugs and bedaquiline-rifabutin combinations against actively multiplying and nutrient-starved Mycobacterium abscessus

2020 ◽  
Author(s):  
Jin Lee ◽  
Nicole Ammerman ◽  
Anusha Agarwal ◽  
Maram Naji ◽  
Si-Yang Li ◽  
...  
Keyword(s):  
Bactericidal Activity ◽  
Treatment Options ◽  
Current Treatment ◽  
Mycobacterium Abscessus ◽  
Bacterial Populations ◽  
Treatment Regimens ◽  
Novel Treatment ◽  
Limited Effectiveness ◽  
Dependent Activity

AbstractCurrent treatment options for lung disease caused by Mycobacterium abscessus complex infections have limited effectiveness. To maximize the use of existing antibacterials and to help inform regimen design for treatment, we assessed the in vitro bactericidal activity of single drugs against actively multiplying and net non-replicating M. abscessus populations in nutrient-rich and nutrient starvation conditions, respectively. As single drugs, bedaquiline and rifabutin exerted bactericidal activity only against nutrient-starved and actively growing M. abscessus, respectively. However, when combined, both bedaquiline and rifabutin were able to specifically contribute bactericidal activity at relatively low, clinically relevant concentrations against both replicating and non-replicating bacterial populations. The addition of a third drug, amikacin, further enhanced the bactericidal activity of the bedaquiline-rifabutin combination against nutrient-starved M. abscessus. Overall, these in vitro data suggest that bedaquiline-rifabutin may be a potent backbone combination to support novel treatment regimens for M. abscessus infections. This rich dataset of differential time-and concentration-dependent activity of drugs, alone and together, against M. abscessus also highlights several issues affecting interpretation and translation of in vitro findings.

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