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<p>The rise in antibiotic resistance among Gram-negative bacteria poses significant challenges to global health. This study evaluates the in vitro efficacy of tigecycline, omadacycline, and eravacycline against clinical isolates harboring the mobile tigecycline resistance genes <i>tet</i>(X4) and <i>tet</i>(A). A total of 175 clinical strains collected between 1999 and 2023 were analyzed. Resistance genes, including <i>tet</i>(X4) and <i>tet</i>(A), were determined using Polymerase chain reaction (PCR). Minimum inhibitory concentrations (MICs) were determined using the broth microdilution method. Eravacycline exhibited significantly lower MIC values than those of tigecycline for <i>Escherichia coli</i> carrying <i>tet</i>(X4) (<i>P</i> &lt; 0.0001), despite similar resistance rates. Omadacycline consistently displayed the highest MIC values, indicating reduced potency. In contrast, <i>Klebsiella pneumoniae</i> carrying <i>tet</i>(A) showed higher MIC values for eravacycline than tigecycline. Universal resistance was observed in <i>Enterobacter&#xa0;cloacae</i> carrying <i>tet</i>(A). Eravacycline demonstrated superior in vitro efficacy, particularly against <i>E. coli</i> carrying <i>tet</i>(X4), underscoring its potential as a therapeutic option for multidrug-resistant infections. MIC values should complement resistance rates in clinical decision-making, and further studies are warranted to validate eravacycline’s clinical utility.</p>

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Comparative efficacy of eravacycline and tigecycline in addressing multidrug-resistant Gram-negative bacteria

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月21日

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  • Jing Zhang,
  • Hanyu Wang,
  • Aoxiao Chen,
  • Ning Dong,
  • Hongwei Zhou,
  • Kewei Li

摘要

The rise in antibiotic resistance among Gram-negative bacteria poses significant challenges to global health. This study evaluates the in vitro efficacy of tigecycline, omadacycline, and eravacycline against clinical isolates harboring the mobile tigecycline resistance genes tet(X4) and tet(A). A total of 175 clinical strains collected between 1999 and 2023 were analyzed. Resistance genes, including tet(X4) and tet(A), were determined using Polymerase chain reaction (PCR). Minimum inhibitory concentrations (MICs) were determined using the broth microdilution method. Eravacycline exhibited significantly lower MIC values than those of tigecycline for Escherichia coli carrying tet(X4) (P < 0.0001), despite similar resistance rates. Omadacycline consistently displayed the highest MIC values, indicating reduced potency. In contrast, Klebsiella pneumoniae carrying tet(A) showed higher MIC values for eravacycline than tigecycline. Universal resistance was observed in Enterobacter cloacae carrying tet(A). Eravacycline demonstrated superior in vitro efficacy, particularly against E. coli carrying tet(X4), underscoring its potential as a therapeutic option for multidrug-resistant infections. MIC values should complement resistance rates in clinical decision-making, and further studies are warranted to validate eravacycline’s clinical utility.