{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T11:26:50Z","timestamp":1771327610133,"version":"3.50.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"vor","delay-in-days":54,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015512","name":"Wockhardt Ltd","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100015512","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>India is among the nations reporting substantial healthcare burden linked to pneumococcal infections. Nafithromycin is a novel lactone ketolide antibiotic, which recently entered Phase 3 development in India for the indication of community-acquired bacterial pneumonia (CABP).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the in vitro activity of nafithromycin against serotyped invasive and non-invasive Streptococcus pneumoniae isolates, collected from nine medical centres across India.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A total of 534 isolates of S. pneumoniae were collected during 2015\u201320 and serotyped as per CDC protocol. A subset of erythromycin-non-susceptible S. pneumoniae (n\u2009=\u2009200) was screened for the presence of erm(B) and mef(A\/E) genes. A subset of MDR isolates (n\u2009=\u200954) were also subjected to MLST. The MICs of antibiotics were determined by the reference agar-dilution method (CLSI). Susceptibilities of the comparators were interpreted as per CLSI criteria.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Fifty-nine distinct serotypes were identified among the 534 isolates. Among erythromycin-non-susceptible isolates, erm(B) and mef(A\/E) genes were found in 49% and 59% strains respectively, while MLST showed clonal diversity. Azithromycin (67.6% non-susceptible) and clindamycin (31.8% non-susceptible) showed limited activity. Penicillin (for non-meningitis) or quinolone non-susceptibility was low (&amp;lt;11% and &amp;lt;6%, respectively). Nafithromycin showed potent activity with MIC50 and MIC90 of 0.015\u20130.03 and 0.06\u2009mg\/L, respectively, regardless of the macrolide resistance mechanisms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Indian pneumococcal isolates show poor susceptibilities to macrolides, in concordance with the global trend. Nafithromycin overcomes erm as well as mef-mediated macrolide resistance mechanisms expressed individually or concurrently in S. pneumoniae. This study supports continued clinical development of nafithromycin for pneumococcal infections including CABP.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jacamr\/dlab066","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T19:33:41Z","timestamp":1618601621000},"source":"Crossref","is-referenced-by-count":15,"title":["Activity of novel lactone ketolide nafithromycin against multicentric invasive and non-invasive pneumococcal isolates collected in India"],"prefix":"10.1093","volume":"3","author":[{"given":"Balaji","family":"Veeraraghavan","sequence":"first","affiliation":[{"name":"Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemol","family":"Varghese","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karnika","family":"Saigal","sequence":"additional","affiliation":[{"name":"Chacha Nehru Bal Chikitsalaya, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Balasubramanian","sequence":"additional","affiliation":[{"name":"Kanchi Kamakoti Children\u2019s Trust Hospital, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P Sulochana Putli","family":"Bai","sequence":"additional","affiliation":[{"name":"ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binesh","family":"Lal Y","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayyanraj","family":"Neeravi","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavithra","family":"Baskar","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kavipriya","family":"Anandhan","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C P Girish","family":"Kumar","sequence":"additional","affiliation":[{"name":"ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuvraj","family":"Jayaraman","sequence":"additional","affiliation":[{"name":"ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vijaya Lakshmi","family":"Nag","sequence":"additional","affiliation":[{"name":"All India Institute of 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