OBJECTIVES: We investigated the activity of BAL30072, a dihydroxypyridone monosulfactam, against carbapenem-resistant Enterobacteriaceae and non-fermenters (i) alone, (ii) combined with BAL29880 (to inhibit AmpC) and/or clavulanate [to inhibit extended-spectrum β-lactamases (ESBLs)] and (iii) combined 1:1 with meropenem. METHODS: Isolates were from multiple UK hospitals. MICs were determined by CLSI agar dilution. Carbapenemases were identified by PCR and sequencing. RESULTS: BAL30072 inhibited 69% of the carbapenem-resistant Enterobacteriaceae at ≤4 mg/L, including 60%-87% with OXA-48, IMP, NDM and VIM enzymes or combinations of impermeability with AmpC or ESBL, and 40% with KPC enzymes. The proportions susceptible exceeded 90% for BAL30072+BAL29880+clavulanate, except for isolates with KPC carbapenemases, where members of the international sequence type (ST) 258 Klebsiella pneumoniae clone remained resistant. At 4 mg/L, BAL30072 was active against all OprD-deficient Pseudomonas aeruginosa, against 8/12 with efflux-type β-lactam resistance and 19/25 with metallo-carbapenemases; these proportions were little increased if inhibitors were added. Most Acinetobacter baumannii with OXA or NDM carbapenemases were susceptible to BAL30072 alone at ≤4 mg/L, but those with OXA-58 were resistant, probably for reasons other than their β-lactamase. Addition of meropenem to BAL30072 increased activity against some individual isolates, but with little clear relationship to the resistance mechanism, except for consistent potentiation against OprD-deficient P. aeruginosa. CONCLUSIONS: BAL30072 had good activity against many diverse carbapenem resistance types. Adding clavulanate and/or BAL29880 extended activity against carbapenem-resistant Enterobacteriaceae, but not non-fermenters. Adding meropenem resulted in small increases in activity against individual isolates. Resistance remained common in the K. pneumoniae ST258 KPC clone, even with both inhibitors or meropenem added.
OBJECTIVES: We investigated the activity of BAL30072, a dihydroxypyridone monosulfactam, against carbapenem-resistant Enterobacteriaceae and non-fermenters (i) alone, (ii) combined with BAL29880 (to inhibit AmpC) and/or clavulanate [to inhibit extended-spectrum β-lactamases (ESBLs)] and (iii) combined 1:1 with meropenem. METHODS: Isolates were from multiple UK hospitals. MICs were determined by CLSI agar dilution. Carbapenemases were identified by PCR and sequencing. RESULTS: BAL30072 inhibited 69% of the carbapenem-resistant Enterobacteriaceae at ≤4 mg/L, including 60%-87% with OXA-48, IMP, NDM and VIM enzymes or combinations of impermeability with AmpC or ESBL, and 40% with KPC enzymes. The proportions susceptible exceeded 90% for BAL30072+BAL29880+clavulanate, except for isolates with KPC carbapenemases, where members of the international sequence type (ST) 258 Klebsiella pneumoniae clone remained resistant. At 4 mg/L, BAL30072 was active against all OprD-deficient Pseudomonas aeruginosa, against 8/12 with efflux-type β-lactam resistance and 19/25 with metallo-carbapenemases; these proportions were little increased if inhibitors were added. Most Acinetobacter baumannii with OXA or NDM carbapenemases were susceptible to BAL30072 alone at ≤4 mg/L, but those with OXA-58 were resistant, probably for reasons other than their β-lactamase. Addition of meropenem to BAL30072 increased activity against some individual isolates, but with little clear relationship to the resistance mechanism, except for consistent potentiation against OprD-deficient P. aeruginosa. CONCLUSIONS: BAL30072 had good activity against many diverse carbapenem resistance types. Adding clavulanate and/or BAL29880 extended activity against carbapenem-resistant Enterobacteriaceae, but not non-fermenters. Adding meropenem resulted in small increases in activity against individual isolates. Resistance remained common in the K. pneumoniae ST258 KPC clone, even with both inhibitors or meropenem added.
Entities:
Keywords:
KPC carbapenemases; NDM carbapenemases; OXA carbapenemases; VIM carbapenemases; monosulfactam
Authors: Thomas M Harper; Cynthia M June; Magdalena A Taracila; Robert A Bonomo; Rachel A Powers; David A Leonard Journal: Biochem J Date: 2018-01-11 Impact factor: 3.857
Authors: Joshua M Mitchell; Jozlyn R Clasman; Cynthia M June; Kip-Chumba J Kaitany; James R LaFleur; Magdalena A Taracila; Neil V Klinger; Robert A Bonomo; Troy Wymore; Agnieszka Szarecka; Rachel A Powers; David A Leonard Journal: Biochemistry Date: 2015-03-02 Impact factor: 3.162
Authors: L Silvia Munoz-Price; Laurent Poirel; Robert A Bonomo; Mitchell J Schwaber; George L Daikos; Martin Cormican; Giuseppe Cornaglia; Javier Garau; Marek Gniadkowski; Mary K Hayden; Karthikeyan Kumarasamy; David M Livermore; Juan J Maya; Patrice Nordmann; Jean B Patel; David L Paterson; Johann Pitout; Maria Virginia Villegas; Hui Wang; Neil Woodford; John P Quinn Journal: Lancet Infect Dis Date: 2013-09 Impact factor: 25.071