Fosfomycin plus Beta-lactams: Synergistic Bactericidal Combinations in Methicillin-resistant (MRSA) and Glycopeptide-Intermediate Resistant (GISA) Staphylococcus aureus Experimental Endocarditis

The urgent need of effective therapies for methicillin-resistant Staphylococcus aureus (MRSA) infective endocarditis (IE) is a cause of concern. We aimed to ascertain the in vitro and in vivo activity of the older antibiotic fosfomycin combined with different beta-lactams against MRSA and glycopepti...

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Autores: Rio Fernández, Antonio del, García de la Mària, Cristina, Entenza, José Manuel, Gasch, Oriol, Armero, Yolanda, Soy Muner, Dolors, Mestres Lucio, Carlos-Alberto, Pericàs, Juan M., Falces Salvador, Carles, Ninot, Salvador, Almela, M. (Manel), Cervera, Carlos, Gatell, José M., Moreno Camacho, Ma. Asunción, Moreillon, Philippe, Marco Reverté, Francesc, Miró Meda, José M. (José María), 1956-, Hospital Clínic Experimental Endocarditis Study Group
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2016
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/184262
Acceso en línea:https://hdl.handle.net/2445/184262
Access Level:acceso abierto
Palabra clave:Endocarditis
Antibiòtics
Antibiotics
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spelling Fosfomycin plus Beta-lactams: Synergistic Bactericidal Combinations in Methicillin-resistant (MRSA) and Glycopeptide-Intermediate Resistant (GISA) Staphylococcus aureus Experimental EndocarditisRio Fernández, Antonio delGarcía de la Mària, Cristina Entenza, José ManuelGasch, OriolArmero, YolandaSoy Muner, DolorsMestres Lucio, Carlos-AlbertoPericàs, Juan M.Falces Salvador, CarlesNinot, SalvadorAlmela, M. (Manel)Cervera, CarlosGatell, José M.Moreno Camacho, Ma. AsunciónMoreillon, PhilippeMarco Reverté, FrancescMiró Meda, José M. (José María), 1956-Hospital Clínic Experimental Endocarditis Study GroupEndocarditisAntibiòticsEndocarditisAntibioticsThe urgent need of effective therapies for methicillin-resistant Staphylococcus aureus (MRSA) infective endocarditis (IE) is a cause of concern. We aimed to ascertain the in vitro and in vivo activity of the older antibiotic fosfomycin combined with different beta-lactams against MRSA and glycopeptide-intermediate-resistant S. aureus (GISA) strains. Time-kill tests with 10 isolates showed that fosfomycin plus imipenem (FOF+IPM) was the most active evaluated combination. In an aortic valve IE model with two strains (MRSA-277H and GISA-ATCC 700788), the following intravenous regimens were compared: fosfomycin (2 g every 8 h [q8h]) plus imipenem (1 g q6h) or ceftriaxone (2 g q12h) (FOF+CRO) and vancomycin at a standard dose (VAN-SD) (1 g q12h) and a high dose (VAN-HD) (1 g q6h). Whereas a significant reduction of MRSA-227H load in the vegetations (veg) was observed with FOF+IPM compared with VAN-SD (0 [interquartile range [IQR], 0 to 1] versus 2 [IQR, 0 to 5.1] log CFU/g veg; P = 0.01), no statistical differences were found with VAN-HD. In addition, FOF+IPM sterilized more vegetations than VAN-SD (11/15 [73%] versus 5/16 [31%]; P = 0.02). The GISA-ATCC 700788 load in the vegetations was significantly lower after FOF+IPM or FOF+CRO treatment than with VAN-SD (2 [IQR, 0 to 2] and 0 [IQR, 0 to 2] versus 6.5 [IQR, 2 to 6.9] log CFU/g veg; P < 0.01). The number of sterilized vegetations after treatment with FOF+CRO was higher than after treatment with VAN-SD or VAN-HD (8/15 [53%] versus 4/20 [20%] or 4/20 [20%]; P = 0.03). To assess the effect of FOF+IPM on penicillin binding protein (PBP) synthesis, molecular studies were performed, with results showing that FOF+IPM treatment significantly decreased PBP1, PBP2 (but not PBP2a), and PBP3 synthesis. These results allow clinicians to consider the use of FOF+IPM or FOF+CRO to treat MRSA or GISA IE.Copyright © 2015, American Society for Microbiology. All Rights Reserved.American Society for Microbiology2016info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/184262Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del postprint publicat a: https://doi.org/10.1128/AAC.02139-15Antimicrobial Agents And Chemotherapy, 2015, vol 60, num 1, p. 478-486https://doi.org/10.1128/AAC.02139-15(c) American Society for Microbiology, 2015info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1842622026-05-27T06:46:51Z
dc.title.none.fl_str_mv Fosfomycin plus Beta-lactams: Synergistic Bactericidal Combinations in Methicillin-resistant (MRSA) and Glycopeptide-Intermediate Resistant (GISA) Staphylococcus aureus Experimental Endocarditis
title Fosfomycin plus Beta-lactams: Synergistic Bactericidal Combinations in Methicillin-resistant (MRSA) and Glycopeptide-Intermediate Resistant (GISA) Staphylococcus aureus Experimental Endocarditis
spellingShingle Fosfomycin plus Beta-lactams: Synergistic Bactericidal Combinations in Methicillin-resistant (MRSA) and Glycopeptide-Intermediate Resistant (GISA) Staphylococcus aureus Experimental Endocarditis
Rio Fernández, Antonio del
Endocarditis
Antibiòtics
Endocarditis
Antibiotics
title_short Fosfomycin plus Beta-lactams: Synergistic Bactericidal Combinations in Methicillin-resistant (MRSA) and Glycopeptide-Intermediate Resistant (GISA) Staphylococcus aureus Experimental Endocarditis
title_full Fosfomycin plus Beta-lactams: Synergistic Bactericidal Combinations in Methicillin-resistant (MRSA) and Glycopeptide-Intermediate Resistant (GISA) Staphylococcus aureus Experimental Endocarditis
title_fullStr Fosfomycin plus Beta-lactams: Synergistic Bactericidal Combinations in Methicillin-resistant (MRSA) and Glycopeptide-Intermediate Resistant (GISA) Staphylococcus aureus Experimental Endocarditis
title_full_unstemmed Fosfomycin plus Beta-lactams: Synergistic Bactericidal Combinations in Methicillin-resistant (MRSA) and Glycopeptide-Intermediate Resistant (GISA) Staphylococcus aureus Experimental Endocarditis
title_sort Fosfomycin plus Beta-lactams: Synergistic Bactericidal Combinations in Methicillin-resistant (MRSA) and Glycopeptide-Intermediate Resistant (GISA) Staphylococcus aureus Experimental Endocarditis
dc.creator.none.fl_str_mv Rio Fernández, Antonio del
García de la Mària, Cristina
Entenza, José Manuel
Gasch, Oriol
Armero, Yolanda
Soy Muner, Dolors
Mestres Lucio, Carlos-Alberto
Pericàs, Juan M.
Falces Salvador, Carles
Ninot, Salvador
Almela, M. (Manel)
Cervera, Carlos
Gatell, José M.
Moreno Camacho, Ma. Asunción
Moreillon, Philippe
Marco Reverté, Francesc
Miró Meda, José M. (José María), 1956-
Hospital Clínic Experimental Endocarditis Study Group
author Rio Fernández, Antonio del
author_facet Rio Fernández, Antonio del
García de la Mària, Cristina
Entenza, José Manuel
Gasch, Oriol
Armero, Yolanda
Soy Muner, Dolors
Mestres Lucio, Carlos-Alberto
Pericàs, Juan M.
Falces Salvador, Carles
Ninot, Salvador
Almela, M. (Manel)
Cervera, Carlos
Gatell, José M.
Moreno Camacho, Ma. Asunción
Moreillon, Philippe
Marco Reverté, Francesc
Miró Meda, José M. (José María), 1956-
Hospital Clínic Experimental Endocarditis Study Group
author_role author
author2 García de la Mària, Cristina
Entenza, José Manuel
Gasch, Oriol
Armero, Yolanda
Soy Muner, Dolors
Mestres Lucio, Carlos-Alberto
Pericàs, Juan M.
Falces Salvador, Carles
Ninot, Salvador
Almela, M. (Manel)
Cervera, Carlos
Gatell, José M.
Moreno Camacho, Ma. Asunción
Moreillon, Philippe
Marco Reverté, Francesc
Miró Meda, José M. (José María), 1956-
Hospital Clínic Experimental Endocarditis Study Group
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Endocarditis
Antibiòtics
Endocarditis
Antibiotics
topic Endocarditis
Antibiòtics
Endocarditis
Antibiotics
description The urgent need of effective therapies for methicillin-resistant Staphylococcus aureus (MRSA) infective endocarditis (IE) is a cause of concern. We aimed to ascertain the in vitro and in vivo activity of the older antibiotic fosfomycin combined with different beta-lactams against MRSA and glycopeptide-intermediate-resistant S. aureus (GISA) strains. Time-kill tests with 10 isolates showed that fosfomycin plus imipenem (FOF+IPM) was the most active evaluated combination. In an aortic valve IE model with two strains (MRSA-277H and GISA-ATCC 700788), the following intravenous regimens were compared: fosfomycin (2 g every 8 h [q8h]) plus imipenem (1 g q6h) or ceftriaxone (2 g q12h) (FOF+CRO) and vancomycin at a standard dose (VAN-SD) (1 g q12h) and a high dose (VAN-HD) (1 g q6h). Whereas a significant reduction of MRSA-227H load in the vegetations (veg) was observed with FOF+IPM compared with VAN-SD (0 [interquartile range [IQR], 0 to 1] versus 2 [IQR, 0 to 5.1] log CFU/g veg; P = 0.01), no statistical differences were found with VAN-HD. In addition, FOF+IPM sterilized more vegetations than VAN-SD (11/15 [73%] versus 5/16 [31%]; P = 0.02). The GISA-ATCC 700788 load in the vegetations was significantly lower after FOF+IPM or FOF+CRO treatment than with VAN-SD (2 [IQR, 0 to 2] and 0 [IQR, 0 to 2] versus 6.5 [IQR, 2 to 6.9] log CFU/g veg; P < 0.01). The number of sterilized vegetations after treatment with FOF+CRO was higher than after treatment with VAN-SD or VAN-HD (8/15 [53%] versus 4/20 [20%] or 4/20 [20%]; P = 0.03). To assess the effect of FOF+IPM on penicillin binding protein (PBP) synthesis, molecular studies were performed, with results showing that FOF+IPM treatment significantly decreased PBP1, PBP2 (but not PBP2a), and PBP3 synthesis. These results allow clinicians to consider the use of FOF+IPM or FOF+CRO to treat MRSA or GISA IE.Copyright © 2015, American Society for Microbiology. All Rights Reserved.
publishDate 2016
dc.date.none.fl_str_mv 2016
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/184262
url https://hdl.handle.net/2445/184262
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del postprint publicat a: https://doi.org/10.1128/AAC.02139-15
Antimicrobial Agents And Chemotherapy, 2015, vol 60, num 1, p. 478-486
https://doi.org/10.1128/AAC.02139-15
dc.rights.none.fl_str_mv (c) American Society for Microbiology, 2015
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) American Society for Microbiology, 2015
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv American Society for Microbiology
publisher.none.fl_str_mv American Society for Microbiology
dc.source.none.fl_str_mv Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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