DOCSLIB.ORG

Kanamycin Group Antibiotics Were Subjected to Enzymatic Acetylation

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Kanamycin Group Antibiotics Were Subjected to Enzymatic Acetylation VOL. 51 NO. 8 THE JOURNAL OF ANTIBIOTICS 735 The Novel Enzymatic 3"-N-Acetylation of Arbekacin by an Aminoglycoside 3-N-Acetyltransferase of Streptomyces Origin and the Resulting Activity † KUNIMOTO HOTTA*, ATSUKO SUNADA, JUN ISHIKAWA and SATOSHI MIZUNO National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan YOKO IKEDA and SHINICHI KONDO Institute of Microbial Chemistry, 3-14-23 Kamiosaki, Shinagawa-ku, Tokyo 141-0021, Japan (Received for publication May 19, 1998) Kanamycin group antibiotics were subjected to enzymatic acetylation by a cell free extract containing an aminoglycoside 3-N-acetyltransferase, AAC (3)-X, derived from Streptomyces griseus SS-1198PR. Characterization of the incubated reaction mixtures by TLC and antibiotic assay revealed that a product retaining activity was specifically formed from arbekacin, an anti-MRSA semisynthetic aminoglycoside. The structural determination demonstrated that acetylation occurred at the 3"-amino group in arbekacin and amikacin, and at the 3-amino group in dibekacin as in the case of kanamycin. These results should reflected the effect of the (S)-4-amino-2-hydroxybutyryl side chain which is present in arbekacin and amikacin, but absent in dibekacin and kanamycin. The 3"-N acetylation is the first finding in the enzymatic modifications of aminoglycoside antibiotics. 3"-N-Acetylarbekacin showed antibiotic activity as high as that of 2'-N acetylarbekacin reported previously, whereas 3"-N-acetylamikacin showed no substantial activity. Thus, our results illuminated a novel aspect of arbekacin distinct from the other aminoglycosides. Enzymatic mechanisms of resistance to aminoglyco- excellent activity against all of methicillin-resistant side antibiotics were first reported in 1967 by UMEZAWA Staphylococcus aureus (MRSA) strains containing any and his colleagues. 1,2) They demonstrated all the three sort of aminoglycoside-modifying enzyme available in types of aminoglycoside-modifying enzymes in clinically- the 1980s. Therefore, ABK was approved as a chemo- isolated resistant bacteria carrying R plasmids; i.e., an therapeutic agent for the treatment of infections caused aminoglycoside acetyltransferase, AAC(6')3) as well as a by MRSA, since 1990 in Japan,9～11) and has been used phosphotransferase, APH(3'),4) that inactivated kanamy- extensively until today. Only a small number of MRSA cin (KM), and an adenylyltransferase, AAD(3"),5) that strains with a moderate level (12.5～25μg/ml) of inactivated streptomycin (SM). On the basis of these ABK-resistance due to a bifunctional enzyme APH(2")/ findings, they predicted structures refractory to these AAC(6') have emerged12,13) so that the incidence of enzymes and eventually synthesized dibekacin (DKB) as ABK-registant MRSA strains has been very low. How- the first rationally designed semisynthetic aminoglyco- ever, one cannot rule out the possibility of emergence in side.6) Subsequently, arbekacin (ABK)7) having the the future of novel ABK-resistant strains, since ABK 1-N-[(S)-4-amino-2-hydroxybutyryl] side chain were contains several amino and hydroxyl groups that may synthesized as in the case of amikacin (AMK).8) Among be modified by enzymes such as AAC(3), AAC(2') and a lot of aminoglycoside derivatives synthesized for active AAC(6'). agents against resistant bacteria, only ABK showed an To check these possibility, we attempted to use AACs † A part of this work was presented at ASM General Meeting (96th) that was held on May 21 , 1996 in New Orleans, La. and at the 43rd Annual Meeting of the Eastern Branch of the Japan Society of Chemotherapy held on November 15, 1996 in Tokyo. 736 THE JOURNAL OF ANTIBIOTICS AUG. 1998 Fig. 1. Structures. available from actinomycetes such as aminoglycoside- Results producers. First, we exposed ABK to AAC (2') derived from a kasugamycin-producing strain, Streptomyces In a preliminary study on acetylation with a cell free kasugaensis MB273. Consequently it turned out that extract of S. lividans TK21/pANT3-1 containing the ABK was readily converted to the 2'-N-acetyl derivative AAC (3)-X gene (aac(3)-Xa) cloned from a KM-resistant retaining antibiotic activity, indicating that AAC (2')- mutant of SM-producing S. griseus SS-1198, ABK was dependent aminoglycoside resistant bacteria could not completely converted to a single modified product be resistant to ABK.14) While, an inactivated product, monitored by TLC, similar to KM and DKB. The anti- 3-N-acetyl KM was isolated by the enzymatic reaction biotic assay of the reaction mixtures demonstrated that of KM with an AAC (3) obtained from S. griseus SS- no apparent inactivation occurred with ABK suggesting 1198PR, a KM-resistant mutant derived from a wild type that the acetylation product of ABK retained antibiotic SM-producing strain (S. griseus SS-1198). Although this activity as comparable as that of ABK. By contrast, the enzyme was first designated AAC (3)-V,15)it was renamed reaction mixtures of DKB and KM lost the activity.15) AAC(3)-X as a new aminoglycoside-modifying en- While, acetylation of AMK proceeded so slowly that it zyme.16) 16)zyme . was not completed even by 96-hour incubation. In the present study, ABK, AMK and DKB were The acetylated product in the enzymatic reaction exposed to AAC (3)-X of S. griseus origin. Interestingly, mixture of ABK and a cell free extract of S. lividans ABK and AMK that have the same 1-N-aryl side chain TK21/pANT3-1 was isolated by column chromatogra- turned out to be modified by acetylation at the 3"-amino phy on Amberlite CG-50 (NH+4) resin in a good yield. group that has never been reported in any aminoglyco- FAB-MS of the product provided m/z 595 (M+H)+ side, whereas DKB lacking the side chain was converted indicating monoacetylated ABK. As shown in Tables 1 to 3-N-acetyl DKB by the intrinsic action of AAC (3)-X and 2, the 1H and 13C NMR spectra of the acetylated (Fig. 1). In this paper, the formation, isolation, structural product were compared with those of ABK in an acidic elucidation and antimicrobial activity of enzymatic D2O. The 1H NMR spectrum of the product showed an reaction products of ABK, AMK and DKB by AAC (3)- acetyl CH3 signal at δ 2.07 and the 3"-H signal at δ 4.10 X are presented. shifted to lower field than that of ABK (δ 3.45). The 13C VOL. 51 NO. 8 THE JOURNAL OF ANTIBIOTICS 737 Table 1. 1H NMR spectral data. Bold letters show lower-field shifts due to the N-acetylation. NMR spectrum showed an acetyl CO (δ 176.0) and CH3 two known enzymes, AAC (3)-III produced by Pseu- (δ 23.1) signals, and the β-carbons (C-2" and C-4") of domonas aeruginosa PST117) and AAC (3)-IV produced the acetamide group shifted to lower field (δ 70.4 and by Escherichia coli JR225,18) were not able to acetylate 68.3, respectively). Thus, the structure of the product was ABK and AMK, but readily converted KM and DKB elucidated to be 3"-N-acetyl ABK. The enzymatic reac- to the 3-N-acetyl derivatives. tion of AMK by 48-hour incubation gave 3"-N-acetyl Furthermore, a new product, 3"-N-acetyl ABK showed AMK in 35% yield. However, the product of DKB was a substantial antibiotic activity (55% activity of ABK the 3-N-acetyl derivative similar to that of KM.15) against Bacillus subtilis PCI219) as same as 2'-N-acetyl As shown in Table 3, by the enzymatic reaction with ABK (42% activity of ABK).15) Minimum inhibitory the enzyme AAC(3)-X, ABK and AMK that have the concentrations of 3"-N-acetyl ABK are shown in Table 4. same 1-N-acyl side chain, (S)-4-amino-2-hydroxybutyric acid, were converted into 3"-N-acetyl ABK and 3"-N- Discussion acetyl AMK, respectively, instead of 3-N-acetyl prod- ucts. As expected, the modification product of DKB It was surprise to us to learn that AAC (3)-X was was confirmed to be 3-N-acetyl DKB. On the other hand, capable of converting both ABK and AMK to novel 738 THE JOURNAL OF ANTIBIOTICS AUG. 1998 Table 2. 13C NMR spectral data. Bold letters show β-carbon shifts due to the N-acetylation. Table 3. Enzymatic N-acetylation of aminoglycoside antibiotics. MICs against enzyme-producing strains are shown in parentheses. monoacetylated derivatives, 3"-N-acetyl ABK and 3"- ABK and AMK. The 3"-N-acetylation will take place N-acetyl AMK, respectively, while the enzyme produced on the opposite side of the 3-amino group possibly due 3-N-acetyl derivatives of both KM and DKB as we to the effect of the side chain. The long arm of the expected. The 3"-N-acetylation should reflect a steric panthoteine residue in acetyl CoA molecule may also be hindrance effect of the acyl side chain common to both critical to the 3"-N-acetylation. It should also be noted VOL. 51 NO. 8 THE JOURNAL OF ANTIBIOTICS 739 Table 4. Minimum inhibitory concentrations of 3"AcABK and ABK . 740 THE JOURNAL OF ANTIBIOTICS AUG. 1998 that AACs derived from P, aeruginosa and E, coli failed were obtained from Meiji Seika Kaisha, Ltd. Other to do the 3"-N-acetylation, although these enzymes chemicals were commercially available. produced 3-N-acetyl derivatives from KM and DKB. This means that AAC (3)-X has a unique catalytic prop- Antibiotic Activity erty. Antimicrobial activities against Bacillus subtilis The other point to note is that 3"-N-acetyl ABK PCI219 were determined by an ordinary cup or paper showed a substantial antibiotic activity whereas no sig- disc method in Mycin Assay Agar (Difco).
Load more

Recommended publications
  • Comparison of Arbekacin and Vancomycin in Treatment of Chronic Suppurative Otitis Media by Methicillin Resistant Staphylococcus Aureus
    ORIGINAL ARTICLE Infectious Diseases, Microbiology & Parasitology http://dx.doi.org/10.3346/jkms.2015.30.6.688 • J Korean Med Sci 2015; 30: 688-693 Comparison of Arbekacin and Vancomycin in Treatment of Chronic Suppurative Otitis Media by Methicillin Resistant Staphylococcus aureus Ji-Hee Hwang,1 Ju-Hyung Lee,2,4 Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of ear infections. We Jeong-Hwan Hwang,3 Kyung Min Chung,5 attempted to evaluate the clinical usefulness of arbekacin in treating chronic suppurative Eun-Jung Lee,6 Yong-Joo Yoon,4,6 otitis media (CSOM) by comparing its clinical efficacy and toxicity with those of Mi-Kyoung Moon,1 Ju-Sin Kim,1 vancomycin. Efficacy was classified according to bacterial elimination or bacteriologic 1 3,4 Kyoung-Suk Won, and Chang-Seop Lee failure and improved or failed clinical efficacy response. Ninety-five subjects were diagnosed with CSOM caused by MRSA. Twenty of these subjects were treated with 1Department of Pharmacy, Chonbuk National University Hospital, Jeonju; Departments of arbekacin, and 36 with vancomycin. The bacteriological efficacy (bacterial elimination, 2Preventive Medicine and 3Internal Medicine, arbekacin vs. vancomycin: 85.0% vs. 97.2%) and improved clinical efficacy (arbekacin vs. Chonbuk National University Medical School, vancomycin; 90.0% vs. 97.2%) were not different between the two groups. However, the 4 Jeonju; Research Institute of Clinical Medicine of rate of complications was higher in the vancomycin group (33.3%) than in the arbekacin Chonbuk National University-Chonbuk National University Hospital, Jeonju; Departments of group (5.0%) (P = 0.020). In addition, a total of 12 adverse reactions were observed in the 5Microbiology & Immunology, and 6Otolaryngology- vancomycin group; two for hepatotoxicity, one for nephrotoxicity, eight for leukopenia, Head and Neck Surgery, Chonbuk National two for skin rash, and one for drug fever.
    [Show full text]
  • Double Stage Activity in Aminoglycoside Antibiotics
    VOL.53 NO. 10, OCT.2000 THE JOURNAL OF ANTIBIOTICS pp.1168 - 1174 Double Stage Activity in Aminoglycoside Antibiotics Kunimoto Hotta, Atsuko Sunada, Yoko Ikeda1" and Shinichi Kondo1" National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan f Institute of Microbial Chemistry, 3-14-23 Kamiosaki, Shinagawa-ku, Tokyo 141-0021, Japan (Received for publication July 5, 2000) Fourteen different aminoglycoside antibiotics (AGs) were challenged with aminoglycoside acetyltransferases (AACs) of actinomycete origin in order to examine their 'double stage activity' that is arbitrarily defined as antibiotic activity retainable after enzymatic modification. In kanamycin (KM)-group AGs tested [KM, dibekacin (DKB), amikacin and arbekacin (ABK)], ABKretained activity after acetylations by AAC(3), AAC(2') and AAC(6'). DKBalso retained a weak activity after acetylation by AAC(2'). In gentamicin (GM)-group AGs tested [GM, micronomicin, sisomicin (SISO), netilmicin (NTL) and isepamicin], GM, SISO and NTL retained activites after acetylation by AAC(2'). In neomycin (NM)-group AGs tested [ribostamycin, NM,paromomycin], NMretained activity after acetylation by AAC(6') and AAC(2'). None of astromicin (ASTM)-group AGs tested (ASTMand istamycin B) retained activity after acetylation by AAC(2') and AAC(6'). The activities of acetylated ABK derivatives by AAC(3) and AAC(2') were distinctively high, compared to the others. Streptomyces lividans TK21containing the cloned aac genes were markedly sensitive to AGs that retained activities after acetylation, indicating the substantial effect of 'double stage activity'. Aminoglycoside (AG) antibiotics are generally resistant bacteria was developed by introducing (S)-4- inactivated by acetylation, phosphorylation and adenylyl- amino-2-hydroxybutyryl (AHB) side chain at 1-NH2 of ation due to AG acetyltransferases (AACs), AG KM.
    [Show full text]
  • Successful Combination Therapy with Vancomycin and Arbekacin Against Infective Endocarditis Caused by MRSA
    Dec. 2011 THE JAPANESE JOURNAL OF ANTIBIOTICS 64—56 389 ( 45 ) ͗CASE REPORT͘ Successful combination therapy with vancomycin and arbekacin against infective endocarditis caused by MRSA KENTARO TO, NORIKO MIYAKE, YOJI NAGASAKI and NOBUYUKI SHIMONO Department of Clinical Immunology and Rheumatology/ Infectious Diseases, Kyushu University Hospital (Received for publication September 7, 2011) Infective endocarditis caused by methicillin-resistant Staphylococcus aureus (MRSA) is a serious disease and sometimes leads to poor prognosis. We should have several therapeutic options. Arbekacin is one of the aminoglycoside antibiotics, which is more active against MRSA and less nephrotoxic than gentamicin. Here we presented a successfully treated case of severe MRSA endocarditis without any adverse effect by monitoring therapeutic level of vancomycin and arbekacin. Introduction Infective endocarditis is a serious disease and sometimes leads to thrombosis and metastatic in- fections. Methicillin-resistant Staphylococcus aureus (MRSA) endocarditis has a much higher mor- tality than endocarditis caused by methicillin-susceptible Staphylococcus aureus (MSSA)1. In spite of aggressive antimicrobial therapy against MRSA, we sometimes experience the treatment failure. We should have several therapeutic options for this severe infection, however the optimal therapy has not been established yet. Here we experienced a successful MRSA infective endocarditis case treated by combination therapy of vancomycin and arbekacin. Case report A 38-year-old woman (Ht 160 cm, Wt 45 kg) was admitted to a hospital with a month-long his- tory of high fever, chills, general malaise and leukocytosis. She visited the home doctor and was di- agnosed as having upper respiratory infection, however her symptoms did not respond to several short courses of therapy with levofloxacin.
    [Show full text]
  • Automated Hilic-MS/MS Method for Therapeutic Drug Monitoring of Aminoglycoside Antibiotics and Vancomycin
    Automated HILiC-MS/MS Method for Therapeutic Drug Monitoring of Aminoglycoside Antibiotics and Vancomycin Mikaël LEVI1, Daisuke KAWAKAMI2, Jun WATANABE1 1 SHIMADZU Corporation, MS Business Unit, Kyoto, Japan; 2 SHIMADZU Corporation, Clinical & Biotechnology Business Unit, Kyoto, Japan Area Ratio Area Ratio y = 0.005292846x² + 0.04278182x - 0.004441359 y = 0.001371438x² + 0.02132510x + 0.00002051234 6.0 4.50 1. Introduction R² = 0.9974212 R = 0.9987098 R² = 0.9990104 R = 0.9995051 4.25 5.5 Curve Fit: Default (Quadratic) Curve Fit: Default (Quadratic) Weighting: 1/C 4.00 Weighting: Default (1/C^2) Zero: Default (Not Forced) Zero: Default (Not Forced) 5.0 3.75 3.50 4.5 Aminoglycoside antibiotics are used for treatment of severe infections, especially in the case of Arbekacin 3.25 Kanamycin 4.0 3.00 2.75 3.5 Gram-negative bacilli infection. However, aminoglycosides have narrow therapeutic indexes due to 2.50 3.0 2.25 2.00 2.5 their nephrotoxicity. Therefore, the benefit of therapeutic drug monitoring (TDM) for aminoglycoside 1.75 2.0 1.50 1.25 1.5 has been well-established. Vancomycin, a glycopeptide antibiotic, often used with aminoglycosides 1.00 1.0 0.75 0.50 0.5 because of their synergism, is also nephrotoxic and need to be monitored as well. 0.25 0.0 0.00 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 0.0 2.5 5.0 7.5 10.0 12.5 15.0 17.5 20.0 22.5 25.0 27.5 30.0 32.5 35.0 37.5 40.0 42.5 45.0 47.5 50.0 Conc.Ratio (mg/L) Conc.Ratio (mg/L) While LC-MS/MS is now considered as the gold standard method for TDM, many clinical laboratories Area Ratio Area Ratio 13 y = 0.0003193042x² + 0.2404682x - 0.001638089 y = 0.00002521235x² + 0.01160575x - 0.0007537159 R² = 0.9995769 R = 0.9997884 0.65 R² = 0.9997885 R = 0.9998942 12 Curve Fit: Default (Quadratic) 0.60 Curve Fit: Quadratic still use immunoassays.
    [Show full text]
  • Prospects for Circumventing Aminoglycoside Kinase Mediated Antibiotic Resistance
    REVIEW ARTICLE published: 25 June 2013 CELLULAR AND INFECTION MICROBIOLOGY doi: 10.3389/fcimb.2013.00022 Prospects for circumventing aminoglycoside kinase mediated antibiotic resistance Kun Shi 1, Shane J. Caldwell 1, Desiree H. Fong 1* and Albert M. Berghuis 1,2* 1 Groupe de Recherche Axé sur la Structure des Protéines, Department of Biochemistry, McGill University, Montreal, QC, Canada 2 Department of Microbiology and Immunology, McGill University, Montreal, QC, Canada Edited by: Aminoglycosides are a class of antibiotics with a broad spectrum of antimicrobial activity. Marcelo Tolmasky, California state Unfortunately, resistance in clinical isolates is pervasive, rendering many aminoglycosides University Fullerton, USA ineffective. The most widely disseminated means of resistance to this class of antibiotics Reviewed by: is inactivation of the drug by aminoglycoside-modifying enzymes (AMEs). There are two Sylvie Garneau-Tsodikova, University of Michigan, USA principal strategies to overcoming the effects of AMEs. The first approach involves the Maria S. Ramirez, IMPaM design of novel aminoglycosides that can evade modification. Although this strategy has (UBA-CONICET), Argentina yielded a number of superior aminoglycoside variants, their efficacy cannot be sustained in *Correspondence: the long term. The second approach entails the development of molecules that interfere Desiree H. Fong, Groupe de with the mechanism of AMEs such that the activity of aminoglycosides is preserved. Recherche Axé sur la Structure des Protéines, Department of Although such a molecule has yet to enter clinical development, the search for AME Biochemistry, McGill University, inhibitors has been greatly facilitated by the wealth of structural information amassed 3649 Promenade Sir William Osler, in recent years.
    [Show full text]
  • Intracellular Penetration and Effects of Antibiotics On
    antibiotics Review Intracellular Penetration and Effects of Antibiotics on Staphylococcus aureus Inside Human Neutrophils: A Comprehensive Review Suzanne Bongers 1 , Pien Hellebrekers 1,2 , Luke P.H. Leenen 1, Leo Koenderman 2,3 and Falco Hietbrink 1,* 1 Department of Surgery, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; [email protected] (S.B.); [email protected] (P.H.); [email protected] (L.P.H.L.) 2 Laboratory of Translational Immunology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; [email protected] 3 Department of Pulmonology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands * Correspondence: [email protected] Received: 6 April 2019; Accepted: 2 May 2019; Published: 4 May 2019 Abstract: Neutrophils are important assets in defense against invading bacteria like staphylococci. However, (dysfunctioning) neutrophils can also serve as reservoir for pathogens that are able to survive inside the cellular environment. Staphylococcus aureus is a notorious facultative intracellular pathogen. Most vulnerable for neutrophil dysfunction and intracellular infection are immune-deficient patients or, as has recently been described, severely injured patients. These dysfunctional neutrophils can become hide-out spots or “Trojan horses” for S. aureus. This location offers protection to bacteria from most antibiotics and allows transportation of bacteria throughout the body inside moving neutrophils. When neutrophils die, these bacteria are released at different locations. In this review, we therefore focus on the capacity of several groups of antibiotics to enter human neutrophils, kill intracellular S. aureus and affect neutrophil function. We provide an overview of intracellular capacity of available antibiotics to aid in clinical decision making.
    [Show full text]
  • Antibiotics and Antibiotic Resistance
    This is a free sample of content from Antibiotics and Antibiotic Resistance. Click here for more information on how to buy the book. Index A Antifolates. See also specific drugs AAC(60)-Ib-cr, 185 novel compounds, 378–379 ACHN-975 overview, 373–374 clinical studies, 163–164 resistance mechanisms medicinal chemistry, 166 sulfamethoxazole, 378 structure, 162 trimethoprim, 374–378 AcrAB-TolC, 180 Apramycin, structure, 230 AcrD, 236 Arbekacin, 237–238 AdeRS, 257 Avibactam, structure, 38 AFN-1252 Azithromycin mechanism of action, 148, 153 resistance, 291, 295 resistance, 153 structure, 272 structure, 149 Aztreonam, structure, 36 AIM-1, 74 Amicoumacin A, 222 Amikacin B indications, 240 BaeSR, 257 structure, 230 BAL30072, 36 synthesis, 4 BB-78495, 162 Aminoglycosides. See also specific drugs BC-3205, 341, 344 historical perspective, 229–230 BC-7013, 341, 344 indications, 239–241 b-Lactamase. See also specific enzymes mechanism of action, 232 classification novel drugs, 237 class A, 67–71 pharmacodynamics, 238–239 class B, 69–74 pharmacokinetics, 238–239 class C, 69, 74 resistance mechanisms class D, 70, 74–77 aminoglycoside-modifying enzymes evolution of antibiotic resistance, 4 acetyltransferases, 233–235 historical perspective, 67 nucleotidyltransferases, 235 inhibitors phosphotransferases, 235 overview, 37–39 efflux-mediated resistance, 236 structures, 38 molecular epidemiology, 236–237 nomenclature, 67 overview, 17, 233 b-Lactams. See also specific classes and antibiotics ribosomal RNA modifications, 235–236 Enterococcus faecium–resistancemechanisms,
    [Show full text]
  • Summary Report on Antimicrobials Dispensed in Public Hospitals
    Summary Report on Antimicrobials Dispensed in Public Hospitals Year 2014 - 2016 Infection Control Branch Centre for Health Protection Department of Health October 2019 (Version as at 08 October 2019) Summary Report on Antimicrobial Dispensed CONTENTS in Public Hospitals (2014 - 2016) Contents Executive Summary i 1 Introduction 1 2 Background 1 2.1 Healthcare system of Hong Kong ......................... 2 3 Data Sources and Methodology 2 3.1 Data sources .................................... 2 3.2 Methodology ................................... 3 3.3 Antimicrobial names ............................... 4 4 Results 5 4.1 Overall annual dispensed quantities and percentage changes in all HA services . 5 4.1.1 Five most dispensed antimicrobial groups in all HA services . 5 4.1.2 Ten most dispensed antimicrobials in all HA services . 6 4.2 Overall annual dispensed quantities and percentage changes in HA non-inpatient service ....................................... 8 4.2.1 Five most dispensed antimicrobial groups in HA non-inpatient service . 10 4.2.2 Ten most dispensed antimicrobials in HA non-inpatient service . 10 4.2.3 Antimicrobial dispensed in HA non-inpatient service, stratified by service type ................................ 11 4.3 Overall annual dispensed quantities and percentage changes in HA inpatient service ....................................... 12 4.3.1 Five most dispensed antimicrobial groups in HA inpatient service . 13 4.3.2 Ten most dispensed antimicrobials in HA inpatient service . 14 4.3.3 Ten most dispensed antimicrobials in HA inpatient service, stratified by specialty ................................. 15 4.4 Overall annual dispensed quantities and percentage change of locally-important broad-spectrum antimicrobials in all HA services . 16 4.4.1 Locally-important broad-spectrum antimicrobial dispensed in HA inpatient service, stratified by specialty .
    [Show full text]
  • Staphylococcus Aureus, Coagulase-Negative Staphylococci, and Corynebacterium Compared with 10-Years Previous: a Retrospective Observational Study
    RESEARCH ARTICLE The trend of resistance to antibiotics for ocular infection of Staphylococcus aureus, coagulase-negative staphylococci, and Corynebacterium compared with 10-years previous: A retrospective observational study Hideto Deguchi1, Koji Kitazawa1,2*, Kanae Kayukawa1, Eri Kondoh2, Akiko Fukumoto2, Toshihide Yamasaki1, Shigeru Kinoshita3, Chie Sotozono2 a1111111111 a1111111111 1 Baptist Eye Institute, Kyoto, Japan, 2 Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan, 3 Department of Frontier Medical Science and Technology for Ophthalmology, a1111111111 Kyoto, Prefectural University of Medicine, Kyoto, Japan a1111111111 a1111111111 * [email protected] Abstract OPEN ACCESS Citation: Deguchi H, Kitazawa K, Kayukawa K, Objective Kondoh E, Fukumoto A, Yamasaki T, et al. (2018) The trend of resistance to antibiotics for ocular To retrospectively identify epidemiological trends of infection on the ocular surface and infection of Staphylococcus aureus, coagulase- investigate trends of resistance to bacterial antibiotics compared with 10-years previous for negative staphylococci, and Corynebacterium Staphylococcus aureus, coagulase-negative staphylococci (CNS), and Corynebacterium in compared with 10-years previous: A retrospective observational study. PLoS ONE 13(9): e0203705. Japan. https://doi.org/10.1371/journal.pone.0203705 Editor: Karsten Becker, Universitatsklinikum Materials and methods Munster, GERMANY Bacterial isolate samples were collected from the conjunctival sacs of eyes afflicted with Received: July 2, 2018 conjunctivitis, keratitis, dacryocystitis, and hordeolum from September 2004 through Accepted: August 25, 2018 November 2005 (n = 145 isolates) and September 2014 through November 2015 (n = 195 Published: September 7, 2018 isolates) at the Baptist Eye Institute, Kyoto, Japan. The prevalence of methicillin-resistant S. aureus (MRSA), methicillin-resistant CNS (MR-CNS), and fluoroquinolone-resistant Cory- Copyright: © 2018 Deguchi et al.
    [Show full text]
  • In Vitro Antimicrobial Activity of the Aminoglycoside Arbekacin Tested Against Oxacillin-Resistant Staphylococcus Aureus Isolated in Brazilian Hospitals
    130 BJID 2001; 5 (June) In vitro Antimicrobial Activity of the Aminoglycoside Arbekacin Tested Against Oxacillin-Resistant Staphylococcus aureus Isolated in Brazilian Hospitals Julio C. R. Cordeiro, Adriana O. Reis, Eliete A. Miranda, Special Clinical Microbiology Laboratory, Division Helio S. Sader and The Arbekacin Study Group of Infectious Diseases, Universidade Federal de São Paulo, SP, Brazil Arbekacin is an aminoglycoside used in Japan for treating infections caused by gentamicin and oxacillin-resistant S. aureus (ORSA). The objective of this study was to determine the in vitro antimicrobial activity of arbekacin against 454 clinical isolates of ORSA. The isolates were consecutively collected between January and July, 2000, from patients hospitalized in 8 Brazilian medical centers. The antimicrobial susceptibility testing was performed by disk diffusion method according to NCCLS recommendations. The vast majority of the isolates, 453 strains (99.8%), were considered susceptible to arbekacin based on the criteria proposed by the Requirements for Antibiotic Products of Japan. Only 1 isolate (0.2%) was classified as resistant. On the other hand, high rates of resistance were demonstrated for other aminoglycosides, such as gentamicin (97.6% resistance) and amikacin (97.0% resistance). Resistance rate was also high for ciprofloxacin (98.0%). All isolates were considered susceptible to vancomycin. The excellent in vitro antimicrobial activity of arbekacin demonstrated in this study indicates that this antimicrobial agent may play an important role in the treatment of severe ORSA infections, especially those that show poor clinical response with vancomycin monotherapy. Since the aminoglycosides should not be used as monotherapy to treat Gram positive infections, further studies evaluating in vitro and in vivo synergistic activity of arbekacin combinations are necessary to clarify the clinical role of this aminoglycoside.
    [Show full text]
  • Arbekacin – a Ray of Hope to Fight Against Mdr and Xdr Gram-Negative Bacteria in a Scientific and Cost-Effective Way in Indian Scenario
    Online - 2455-3891 Vol 13, Issue 5, 2020 Print - 0974-2441 Research Article ARBEKACIN – A RAY OF HOPE TO FIGHT AGAINST MDR AND XDR GRAM-NEGATIVE BACTERIA IN A SCIENTIFIC AND COST-EFFECTIVE WAY IN INDIAN SCENARIO SOMA SARKAR1, DIPANKAR SARKAR2*, ANJUM NAMHATA1, MANIDEEPA SENGUPTA3 1Department of Microbiology, NRS Medical College, Kolkata, West Bengal, India. 2Internist and Intensivist, ICU Incharge, Columbia Asia Hospital, Salt-lake, Kolkata, West Bengal, India. 3Department of Microbiology, Medical College, Kolkata, West Bengal, India. Email: [email protected] Received: 08 February 2020, Revised and Accepted: 18 March 2020 ABSTRACT Objective: The objective of the study was to see the in vitro activity of arbekacin, a novel aminoglycoside, against multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative bacilli (GNB) so that it can become a good alternative as empirical treatment for severe sepsis. Methods: Identification and antibiotic sensitivity testing of the GNB isolated from the clinical samples were done using the VITEK-II system in a tertiary care hospital, Kolkata. MDR and XDR strains were selected by their definitions and molecular characterization was done by multiplex polymerase chain reaction. The minimum inhibitory concentration (MIC) value of arbekacin was detected by the E-test strip and compared with other aminoglycosides. Results: A total of 140 drug-resistant strains including ESBL- and carbapenemase-producing GNB were selected for the study. Arbekacin showed reduced values of MIC50 and MIC90 compared to other aminoglycosides for most of the drug-resistant GNB. Conclusion: Hence, in this drug-resistant era, arbekacin with the advantage of a single daily dose can be used as an empirical choice in severe sepsis as monotherapy or in combination with other antibiotics such as colistin or polymyxin to fight against MDR and XDR bugs.
    [Show full text]
  • Distribution of Virulence Factors and Resistance Determinants in Three Genotypes of Staphylococcus Argenteus Clinical Isolates in Japan
    pathogens Article Distribution of Virulence Factors and Resistance Determinants in Three Genotypes of Staphylococcus argenteus Clinical Isolates in Japan Meiji Soe Aung 1,* , Noriko Urushibara 1 , Mitsuyo Kawaguchiya 1, Mina Hirose 2, Miyo Ike 3, Masahiko Ito 3 and Nobumichi Kobayashi 1 1 Department of Hygiene, Sapporo Medical University School of Medicine, Hokkaido, Sapporo 060-8556, Japan; [email protected] (N.U.); [email protected] (M.K.); [email protected] (N.K.) 2 Division of Pediatric Dentistry, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu 061-0293, Japan; [email protected] 3 Sapporo Clinical Laboratory, Incorporated, Hokkaido, Sapporo 060-0005, Japan; [email protected] (M.I.); [email protected] (M.I.) * Correspondence: [email protected]; Tel.: +81-11-611-2111 Abstract: Staphylococcus argenteus, a novel staphylococcal species independent of S. aureus, causes a wide spectrum of infectious diseases. As detection of this species from humans and animals has been increasingly reported worldwide, its growing virulence and drug resistance via external genetic determinants has become concerning. In this study, the prevalence and genetic characteristics of virulence factors and drug resistance determinants were investigated for 82 S. argenteus clinical isolates in Hokkaido, Japan, for a one-year period starting in August 2019. These S. argenteus isolates corresponded to 0.66% of the total number of S. aureus isolates collected in the same period. The Citation: Aung, M.S.; Urushibara, N.; most prevalent genotype was sequence type (ST) 2250 and staphylocoagulase (coa) genotype XId Kawaguchiya, M.; Hirose, M.; Ike, M.; (45.1%, n = 37), followed by ST1223-coa XV (30.5%, n = 25) and ST2198-coa XIV (24.4%, n = 20).
    [Show full text]