Potent {beta}-Lactam Enhancer Activity of Zidebactam and WCK 5153 against Acinetobacter baumannii, Including Carbapenemase-Producing Clinical Isolates [PublishAheadOfPrint]

Multidrug-resistant Acinetobacter baumannii has rapidly spread worldwide resulting in a serious threat to hospitalized patients. Zidebactam and WCK 5153 are novel non-β-lactam bicyclo-acyl hydrazide β-lactam enhancer antibiotics being developed to target multidrug-resistant A. baumannii. The objectives of this work were to determine the penicillin-binding protein (PBP) IC₅₀s, OXA-23 inhibition profiles, and antimicrobial activities of zidebactam and WCK 5153, alone and in combination with β-lactams, against multidrug-resistant A. baumannii. MICs and time kill kinetics were performed against an A. baumannii clinical strain producing the carbapenemase OXA-23 and belonging to the widespread European clone II, sequence type 2 (ST2). Inhibition of OXA-23 purified enzyme by zidebactam, WCK 5153, and comparators was assessed. All of the compounds tested displayed K_{i app} values >100 μM indicating poor OXA-23 β-lactamase inhibition. The PBP IC₅₀ values of zidebactam, WCK 5153, cefepime, ceftazidime, meropenem and sulbactam (range of concentrations tested 0.02 - 2 μg/mL) were also determined. Zidebactam and WCK 5153 demonstrated specific high-affinity PBP2 binding in A. baumannii (0.01 μg/mL for both of the compounds). MICs of zidebactam and WCK 5153 were >1024 μg/mL for wild-type and multidrug-resistant Acinetobacter spp. strains. Importantly, combinations of cefepime or sulbactam with 8 μg/mL of zidebactam or WCK 5153 led to a 4- and 8-fold MIC reduction, respectively and showed enhanced killing. Notably, several of the combinations resulted in full bacterial eradication at 24h. We conclude that zidebactam and WCK 5153 are PBP2 inhibitors that show potent β-lactam enhancer effect against A. baumannii, including a multidrug-resistant OXA-23-producing ST2 international clone.

http://ift.tt/2wdStFd