In vitro activity of eravacycline and comparator agents against Gram-negative and Gram-positive bacteria: results from China Antimicrobial Surveillance Network between 2017 and 2019

Objectives This study comprehensively evaluates the in vitro antibacterial activity of eravacycline against a wide range of significant Gram-negative and Gram-positive bacteria collected across China. Methods A total of 1250 non-duplicate clinical isolates representing 12 genera and 21 species were collected from 40 hospitals between 2017 and 2019 across China. Minimal inhibitory concentrations were determined using the broth microdilution method in accordance with the standards set by the Clinical and Laboratory Standards Institute. Results Eravacycline demonstrated potent in vitro activity against most tested bacterial species. The MIC90 values ranged from 0.25 to 2 mg/L for Enterobacterales, except for Proteus vulgaris (4 mg/L). According to the FDA breakpoints, Escherichia coli and Klebsiella pneumoniae exhibited susceptibility rates of 98.9% and 70.9%, respectively. Eravacycline achieved an MIC90 value of 1 mg/L against Acinetobacter baumannii, which was the lowest among all agents tested. For Gram-positive isolates, eravacycline displayed MIC90 values of 0.5 mg/L for MRSA and methicillin-resistant CoNS (MRCNS), 0.03 mg/L for vancomycin-resistant Enterococcus faecium and 0.03 mg/L for Streptococcus pneumoniae, surpassing or equalling tigecycline and markedly outperforming doxycycline. Conclusions This large-scale multicentre surveillance study demonstrated that eravacycline exhibited potent in vitro activity against major multidrug-resistant Gram-negative and Gram-positive pathogens, indicating that it could be a promising therapeutic option for treating infections caused by these strains.