In Vitro Activity of Omadacycline and Comparator Antibiotics against Extended-Spectrum Beta-Lactamase-Producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> Urinary Isolates
Limited oral antibiotic options exist for urinary tract infections (UTI) caused by ESBL-producing Enterobacterales. The aim of the study was to evaluate in vitro activity of omadacycline and comparator antibiotics against clinical ESBL-producing and non-ESBL-producing <i>E. coli</i> and...
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MDPI AG
2023-05-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/6/953 |
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| author | Tyler J. Stone Abdullah Kilic John C. Williamson Elizabeth L. Palavecino |
| author_facet | Tyler J. Stone Abdullah Kilic John C. Williamson Elizabeth L. Palavecino |
| author_sort | Tyler J. Stone |
| collection | DOAJ |
| description | Limited oral antibiotic options exist for urinary tract infections (UTI) caused by ESBL-producing Enterobacterales. The aim of the study was to evaluate in vitro activity of omadacycline and comparator antibiotics against clinical ESBL-producing and non-ESBL-producing <i>E. coli</i> and <i>K. pneumoniae</i> urinary isolates. 102 isolates each of <i>E. coli</i> and <i>K. pneumoniae</i> were collected from clinical urine specimens in 2019. By design, an equal number of each species were included that tested positive and negative for ESBL production. Omadacycline MICs were determined using gradient test strips and compared to MICs of comparator antibiotics as determined by an automated broth microdilution system. Isolates were considered susceptible to omadacycline if the MIC was ≤4 µg/mL for each species. 54.9% of all ESBL-producing isolates were susceptible to omadacycline, but better susceptibility was observed for ESBL-producing <i>E. coli</i> (74.5%). Omadacycline MICs were 2–4 fold lower for <i>E. coli</i> and <i>K. pneumoniae</i> strains not producing ESBL. The omadacycline MIC 50 and 90 values were 4 and 16 µg/mL, respectively, for all isolates studied. 74.5% of all isolates were considered susceptible to omadacycline. MICs were generally lower for <i>E. coli</i> strains with MIC 50 and 90 values of 4 and 8 µg/mL, respectively (87.3% susceptible), compared with <i>K. pneumoniae</i>. Overall, the most active agents were omadacycline and nitrofurantoin, while other comparator antibiotics were less active. Omadacycline represents a promising oral antibiotic for treating UTI caused by ESBL-producing <i>E. coli</i>, particularly when resistance limits other oral options. Prospective, controlled clinical trials are needed to validate these in vitro results. |
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| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T02:50:22Z |
| publishDate | 2023-05-01 |
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| series | Antibiotics |
| spelling | doaj.art-182079939cfa43e8bcbcdd7ed1a1c6812023-11-18T08:59:57ZengMDPI AGAntibiotics2079-63822023-05-0112695310.3390/antibiotics12060953In Vitro Activity of Omadacycline and Comparator Antibiotics against Extended-Spectrum Beta-Lactamase-Producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> Urinary IsolatesTyler J. Stone0Abdullah Kilic1John C. Williamson2Elizabeth L. Palavecino3Department of Pharmacy, Atrium Health Wake Forest Baptist, Winston-Salem, NC 27157, USADepartment of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USADepartment of Pharmacy, Atrium Health Wake Forest Baptist, Winston-Salem, NC 27157, USADepartment of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USALimited oral antibiotic options exist for urinary tract infections (UTI) caused by ESBL-producing Enterobacterales. The aim of the study was to evaluate in vitro activity of omadacycline and comparator antibiotics against clinical ESBL-producing and non-ESBL-producing <i>E. coli</i> and <i>K. pneumoniae</i> urinary isolates. 102 isolates each of <i>E. coli</i> and <i>K. pneumoniae</i> were collected from clinical urine specimens in 2019. By design, an equal number of each species were included that tested positive and negative for ESBL production. Omadacycline MICs were determined using gradient test strips and compared to MICs of comparator antibiotics as determined by an automated broth microdilution system. Isolates were considered susceptible to omadacycline if the MIC was ≤4 µg/mL for each species. 54.9% of all ESBL-producing isolates were susceptible to omadacycline, but better susceptibility was observed for ESBL-producing <i>E. coli</i> (74.5%). Omadacycline MICs were 2–4 fold lower for <i>E. coli</i> and <i>K. pneumoniae</i> strains not producing ESBL. The omadacycline MIC 50 and 90 values were 4 and 16 µg/mL, respectively, for all isolates studied. 74.5% of all isolates were considered susceptible to omadacycline. MICs were generally lower for <i>E. coli</i> strains with MIC 50 and 90 values of 4 and 8 µg/mL, respectively (87.3% susceptible), compared with <i>K. pneumoniae</i>. Overall, the most active agents were omadacycline and nitrofurantoin, while other comparator antibiotics were less active. Omadacycline represents a promising oral antibiotic for treating UTI caused by ESBL-producing <i>E. coli</i>, particularly when resistance limits other oral options. Prospective, controlled clinical trials are needed to validate these in vitro results.https://www.mdpi.com/2079-6382/12/6/953omadacyclineextended-spectrum beta-lactamase (ESBL)urinary tract infections<i>Escherichia coli</i><i>Klebsiella pneumoniae</i> |
| spellingShingle | Tyler J. Stone Abdullah Kilic John C. Williamson Elizabeth L. Palavecino In Vitro Activity of Omadacycline and Comparator Antibiotics against Extended-Spectrum Beta-Lactamase-Producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> Urinary Isolates Antibiotics omadacycline extended-spectrum beta-lactamase (ESBL) urinary tract infections <i>Escherichia coli</i> <i>Klebsiella pneumoniae</i> |
| title | In Vitro Activity of Omadacycline and Comparator Antibiotics against Extended-Spectrum Beta-Lactamase-Producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> Urinary Isolates |
| title_full | In Vitro Activity of Omadacycline and Comparator Antibiotics against Extended-Spectrum Beta-Lactamase-Producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> Urinary Isolates |
| title_fullStr | In Vitro Activity of Omadacycline and Comparator Antibiotics against Extended-Spectrum Beta-Lactamase-Producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> Urinary Isolates |
| title_full_unstemmed | In Vitro Activity of Omadacycline and Comparator Antibiotics against Extended-Spectrum Beta-Lactamase-Producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> Urinary Isolates |
| title_short | In Vitro Activity of Omadacycline and Comparator Antibiotics against Extended-Spectrum Beta-Lactamase-Producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> Urinary Isolates |
| title_sort | in vitro activity of omadacycline and comparator antibiotics against extended spectrum beta lactamase producing i escherichia coli i and i klebsiella pneumoniae i urinary isolates |
| topic | omadacycline extended-spectrum beta-lactamase (ESBL) urinary tract infections <i>Escherichia coli</i> <i>Klebsiella pneumoniae</i> |
| url | https://www.mdpi.com/2079-6382/12/6/953 |
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