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