For decades, the spread of multidrug-resistant (MDR) Acinetobacter baumannii has been rampant in critically ill, hospitalized patients. Traditional antibiotic therapies against this pathogen have been failing, leading to rising concerns over management options for patients. Two new antibiotics, eravacycline and omadacycline, were introduced to the market and have shown promising results in the treatment of Gram-negative infections. Since these drugs are newly available, there is limited in vitro data about their effectiveness against MDR A. baumannii or even susceptible strains. Here, we examined the effectiveness of 22 standard-of-care antibiotics, eravacycline, and omadacycline against susceptible and extensively drug-resistant (XDR) A. baumannii patient isolates from Cooper University Hospital. Furthermore, we examined selected combinations of eravacycline or omadacycline with other antibiotics against an XDR strain. We demonstrated that this collection of strains is largely resistant to monotherapies of carbapenems, fluoroquinolones, folate pathway antagonists, cephalosporins, and most tetracyclines. While clinical breakpoint data are not available for eravacycline or omadacycline, based on minimum inhibitory concentrations, eravacycline was highly effective against these strains. The aminoglycoside amikacin alone and in combination with eravacycline or omadacycline yielded the most promising results. Our comprehensive characterization offers direction in the treatment of this deadly infection in hospitalized patients.

中文翻译：

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评估 Eravacycline 和 Omadacycline 对广泛耐药鲍曼不动杆菌患者分离株的疗效

几十年来，耐多药 (MDR)鲍曼不动杆菌在重症住院患者中的传播十分猖獗。针对这种病原体的传统抗生素疗法一直失败，导致对患者管理选择的担忧日益增加。两种新的抗生素，依拉环素和 omadacycline 被引入市场，并在治疗革兰氏阴性菌感染方面显示出可喜的结果。由于这些药物是新上市的，因此关于它们对 MDR A. baumannii甚至敏感菌株的有效性的体外数据有限。在这里，我们检查了 22 种标准护理抗生素、依拉环素和 omadacycline 对敏感和广泛耐药 (XDR)鲍曼不动杆菌的有效性从库珀大学医院隔离的患者。此外，我们针对 XDR 菌株检查了依拉环素或 omadacycline 与其他抗生素的选定组合。我们证明，这组菌株对碳青霉烯类、氟喹诺酮类、叶酸途径拮抗剂、头孢菌素和大多数四环素的单一疗法具有很大的耐药性。虽然没有依拉环素或 omadacycline 的临床折点数据，但基于最低抑制浓度，依拉环素对这些菌株非常有效。单独的氨基糖苷类阿米卡星以及与依拉环素或奥玛环素联合使用产生了最有希望的结果。我们的综合表征为治疗住院患者的这种致命感染提供了方向。