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BMC Microbiol. 2018 Dec 13;18(1):211. doi: 10.1186/s12866-018-1349-7.

Eravacycline activity against clinical S. aureus isolates from China: in vitro activity, MLST profiles and heteroresistance.

Zhang F1,2,3, Bai B1,2, Xu GJ1,2, Lin ZW1,2,4, Li GQ1,2, Chen Z1,4, Cheng H1,2, Sun X1,2, Wang HY1,2, Chen YW1,2, Zheng JX1,2,4, Deng QW5,6, Yu ZJ7,8.

Author information

1
Department of Infectious Diseases and Quality Control Center of Hospital Infection Management of Shenzhen, Shenzhen Nanshan People's Hospital, Guang Dong Medical University, No 89, Taoyuan Road, Nanshan District, Shenzhen, 518052, China.
2
Shenzhen key laboratory for endogenous infections, Shenzhen Nanshan People's Hospital, Shenzhen University school of medicine, No 89, Taoyuan Road, Nanshan District, Shenzhen, 518052, China.
3
Department of Tuberculosis, Shenzhen Nanshan Center for Chronic Disease Control, No 7, Huaming Road, Nanshan District, Shenzhen, 518054, China.
4
Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, School of Basic Medical Sciences and Shanghai Public Health Clinical Center, Fudan University, Shanghai, 200032, China.
5
Department of Infectious Diseases and Quality Control Center of Hospital Infection Management of Shenzhen, Shenzhen Nanshan People's Hospital, Guang Dong Medical University, No 89, Taoyuan Road, Nanshan District, Shenzhen, 518052, China. qiwendeng@hotmail.com.
6
Shenzhen key laboratory for endogenous infections, Shenzhen Nanshan People's Hospital, Shenzhen University school of medicine, No 89, Taoyuan Road, Nanshan District, Shenzhen, 518052, China. qiwendeng@hotmail.com.
7
Department of Infectious Diseases and Quality Control Center of Hospital Infection Management of Shenzhen, Shenzhen Nanshan People's Hospital, Guang Dong Medical University, No 89, Taoyuan Road, Nanshan District, Shenzhen, 518052, China. yuzhijiansmu@163.com.
8
Shenzhen key laboratory for endogenous infections, Shenzhen Nanshan People's Hospital, Shenzhen University school of medicine, No 89, Taoyuan Road, Nanshan District, Shenzhen, 518052, China. yuzhijiansmu@163.com.

Abstract

BACKGROUND:

Mortality rates for patients with Staphylococcus aureus (S. aureus) infections have improved only modestly in recent decades and S. aureus infections remain a major clinical challenge This study investigated the in vitro antimicrobial activity of erevacycline (erava) against clinical S. aureus isolates from China, as well as the heteroresistance frequency of erava and sequence types (STs) represented in the sample.

RESULTS:

A sample of 328 non-duplicate clinical S. aureus isolates, including 138 methecillin-resistant (MRSA) and 190 methecillin-sensitive (MSSA) isolates, were collected retrospectively in China. Erava exhibited excellent in vitro activity (MIC50 ≤ 0.25 mg/L) against MRSA and MSSA, including isolates harboring Tet specific resistance genes. The frequency of erava heteroresistance in MSSA with erava MICs = 0.5 mg/L was 13.79% (4/29); no MRSA with erava MICs ≤0.5 mg/L exhibited heteroresistance. Heteroresistance- derived clones had no 30S ribosome subunit mutations, but their erava MICs (range, 1-4 mg/L) were suppressed dramatically in the presence of efflux protein inhibitors.

CONCLUSIONS:

Conclusively, erava exhibited excellent in vitro activity against S. aureus, however hints of erava heteroresistance risk and MIC creep were detected, particularly among MSSA with MICs of 0.5 mg/L.

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