# In Vitro Activity of Delafloxacin Against Corynebacterium spp

## TL;DR

This study evaluates how well delafloxacin works against different Corynebacterium species in the lab and finds it is more effective than other fluoroquinolones.

## Contribution

The study introduces delafloxacin as a potential alternative treatment for Corynebacterium infections and evaluates its efficacy compared to other drugs.

## Key findings

- Delafloxacin showed the lowest MIC50/MIC90 values of 0.5/8 mg/L against Corynebacterium isolates.
- Mutations in the QRDR of the gyrA gene were linked to increased resistance to delafloxacin.
- Delafloxacin gradient strips demonstrated high agreement with microdilution methods.

## Abstract

Background/Objectives: The susceptibility of Corynebacterium spp. to antimicrobial agents is species-related, with increasing levels of resistance to fluoroquinolones in several species related to their continued use in clinical practice. The objectives were to determine the in vitro activity of delafloxacin in comparison with other fluoroquinolones against clinical isolates of Corynebacterium spp., to compare MICs of delafloxacin obtained with gradient strips and with reference microdilution, and to investigate the mechanisms related to fluoroquinolone resistance in the tested strains. Methods: Fifty-three clinical isolates, assigned to five species of Corynebacterium spp., were evaluated using reference microdilution for delafloxacin, ciprofloxacin, levofloxacin, and moxifloxacin (with and without reserpine or phenylalanine-arginine β-naphthylamide), and gradient strips for delafloxacin. The QRDR of the gyrA gene was amplified using primers specific to the different species, and mutations were defined after aligning against the corresponding reference sequences. Results: Delafloxacin was the most active compound with MIC50/MIC90 values of 0.5/8 mg/L. Single mutations at the QRDR were observed in isolates, with MICs of delafloxacin ranging from 0.016 to 4 mg/L, while double mutations occurred in isolates, with MICs ranging from 0.125 to 16 mg/L. The delafloxacin gradient strips showed an essential agreement of 88.7%, bias of −5%, and a Kappa index of 0.848. Conclusions: Increased MICs of delafloxacin against Corynebacterium spp. are related to the presence of non-conservative mutations in the QRDR of gyrA. Delafloxacin gradient strips could be a reasonable alternative for use in the clinical routine of the microbiology laboratory. Delafloxacin could represent an alternative for treating infections due to some species of Corynebacterium.