1280. Minocycline Activity Against Acinetobacter baumannii-calcoaceticus Species Complex, Burkholderia Cepacia Complex, and Stenotrophomonas maltophilia from US Hospitals
Authors: Shortridge Dee , Arends S J Ryan , Streit Jennifer M , Castanheira Mariana , Castanheira Mariana 
Published: December 2021

Abstract

Background
Acinetobacter baumannii-calcoaceticus species complex (ACB), Burkholderia cepacia complex (BCC), and Stenotrophomonas maltophilia (SM) are opportunistic non-fermentative organisms that can cause serious hospital-acquired infections in immunocompromised patients. These pathogens are inherently resistant to several common drug classes and often acquire other resistance mechanisms, making them difficult to treat. In this study, we analyzed the susceptibility of contemporary ACB, BCC, and SM isolates to minocycline (MIN), ceftazidime (TAZ), levofloxacin (LEV), and trimethoprim-sulfamethoxazole (T/S). Isolates were collected as a part of the SENTRY Antimicrobial Surveillance Program from 2017-2020.

Methods
Isolates were collected from hospitalized patients in 33 US medical centers. Hospitals submitted 1 isolate per patient per infection episode that met local criteria for being the likely causative pathogen. Identification was performed by the submitting laboratory and confirmed by JMI Laboratories with matrix-assisted laser desorption ionization-time of flight mass spectrometry or other standard methods as required. Isolates were tested for susceptibility (S) to MIN and comparators using the CLSI broth microdilution method. All infection types were included in the analysis. CLSI (2021) breakpoints were applied.

Results
The most common infection that ACB, BCC, and SM were isolated from was pneumonia in hospitalized patients (57.9%, 81.1%, and 73.9%, respectively) followed by skin and skin structure infections for ACB (21.5%) or bloodstream infections for BCC (13.5%) and SM (11.8%). The %S and MIC50/90 values of the 4 drugs tested against the organisms in this study are shown in the table. MIN had the highest %S for ACB (85.9%S) and SM (99.3%S). TAZ had the highest %S (87.8%S) for BCC, while MIN and T/S had similar %S at 82.4%S and 83.8%S, respectively.

Conclusion
MIN had &gt;82% S for the pathogens in this study, which have limited therapeutic alternatives. Options are particularly limited for BCC and SM, which have only 7 drugs with CLSI breakpoints. These in vitro data suggest that MIN remains a useful treatment option for infections caused by ACB, BCC, or SM.

Disclosures
Dee Shortridge, PhD, AbbVie (formerly Allergan) (Research Grant or Support)Melinta Therapeutics, Inc. (Research Grant or Support)Melinta Therapeutics, LLC (Research Grant or Support)Shionogi (Research Grant or Support) S J Ryan Arends, PhD, AbbVie (formerly Allergan) (Research Grant or Support)GlaxoSmithKline, LLC (Research Grant or Support)Melinta Therapeutics, LLC (Research Grant or Support)Nabriva Therapeutics (Research Grant or Support)Spero Therapeutics (Research Grant or Support) Jennifer M. Streit, BS, GlaxoSmithKline, LLC (Research Grant or Support)Melinta Therapeutics, LLC (Research Grant or Support)Shionogi (Research Grant or Support)Spero Therapeutics (Research Grant or Support) Mariana Castanheira, PhD, AbbVie (formerly Allergan) (Research Grant or Support)Bravos Biosciences (Research Grant or Support)Cidara Therapeutics, Inc. (Research Grant or Support)Cipla Therapeutics (Research Grant or Support)Cipla USA Inc. (Research Grant or Support)GlaxoSmithKline (Research Grant or Support)Melinta Therapeutics, Inc. (Research Grant or Support)Melinta Therapeutics, LLC (Research Grant or Support)Pfizer, Inc. (Research Grant or Support)Qpex Biopharma (Research Grant or Support)Shionogi (Research Grant or Support)Spero Therapeutics (Research Grant or Support) Mariana Castanheira, PhD, Affinity Biosensors (Individual(s) Involved: Self): Research Grant or Support; Allergan (Individual(s) Involved: Self): Research Grant or Support; Amicrobe, Inc (Individual(s) Involved: Self): Research Grant or Support; Amplyx Pharma (Individual(s) Involved: Self): Research Grant or Support; Artugen Therapeutics USA, Inc. (Individual(s) Involved: Self): Research Grant or Support; Astellas (Individual(s) Involved: Self): Research Grant or Support; Basilea (Individual(s) Involved: Self): Research Grant or Support; Beth Israel Deaconess Medical Center (Individual(s) Involved: Self): Research Grant or Support; BIDMC (Individual(s) Involved: Self): Research Grant or Support; bioMerieux Inc. (Individual(s) Involved: Self): Research Grant or Support; BioVersys Ag (Individual(s) Involved: Self): Research Grant or Support; Bugworks (Individual(s) Involved: Self): Research Grant or Support; Cidara (Individual(s) Involved: Self): Research Grant or Support; Cipla (Individual(s) Involved: Self): Research Grant or Support; Contrafect (Individual(s) Involved: Self): Research Grant or Support; Cormedix (Individual(s) Involved: Self): Research Grant or Support; Crestone, Inc. 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