dibekacin and Klebsiella-Infections

This study describes highly aminoglycoside-resistant Klebsiella pneumoniae and Klebsiella oxytoca clinical isolates obtained from an inpatient in Okinawa, Japan, with no known record of traveling overseas. The minimum inhibitory concentrations of amikacin and arbekacin against these strains were >1024 μg/ml. Whole-genome sequencing analysis revealed that these isolates harbored armA, which encodes a 16S rRNA methylase, ArmA, that confers pan-aminoglycoside resistance. This is the second report of K. pneumoniae harboring armA and the first report of K. oxytoca harboring a 16S rRNA methylase encoding gene in Japan.

Topics: Aged; Amikacin; Aminoglycosides; Anti-Bacterial Agents; Dibekacin; Drug Resistance, Bacterial; Female; Humans; Japan; Klebsiella Infections; Klebsiella oxytoca; Klebsiella pneumoniae; Methyltransferases; Microbial Sensitivity Tests; Whole Genome Sequencing

The serum concentration of dibekacin (DKB) were determined in 4 healthy adult volunteers after intramuscular injection, intravenous injection and 1-hour or 2-hour intravenous drip infusion of 100 mg of DKB, and 1-hour drip infusion of 50 mg. The mean peak concentration after the 2-hour drip infusion of 100 mg of DKB was a rather low level. While the 1-hour drip infusion of 50 mg of DKB produced a peak concentration of 7.9 micrograms/ml, which is comparable to that after intramuscular injection of 100 mg. In the cases of the 1-hour drip infusion of 100 mg, the peak serum level reached 13.3 micrograms/ml, which is a relatively higher level than that after intramuscular injection of the same dose. Based on the above findings, it is suggested that the 1-hour intravenous drip infusion of DKB in doses of 50 mg to 100 mg be practically applied for therapeutic use.

Topics: Adult; Animals; Anti-Bacterial Agents; Dibekacin; Humans; Infusions, Parenteral; Injections, Intramuscular; Injections, Intravenous; Kanamycin; Klebsiella Infections; Lung; Male; Mice; Pneumonia