Study on the Decontamination Effect of Eravacycline on Multidrug-Resistant Bacteria in Hypothermic Organ Preservation Solution

Organ preservation solutions (PS) contaminated with multidrug-resistant bacteria (MDRB) risk donor-derived infections in transplantation. Eravacycline (ERV), a novel tetracycline antibiotic, shows potent activity against MDRB, but its efficacy in hypothermic PS (0°C-4°C) is unverified. In this study, six multidrug-resistant bacterial strains-including carbapenem-resistant <i>Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli</i>, VIM-positive <i>Pseudomonas aeruginosa</i>, carbapenemase-negative <i>P. aeruginosa</i>, and methicillin-resistant <i>Staphylococcus aureus</i>-were exposed to eravacycline diluted in preservation solution at concentrations of 25, 50, 100, and 200 mg/L for three hours at 0-4°C. Bacterial viability was assessed by colony-forming unit counts after incubation. Results showed that eravacycline at 25 mg/L inhibited methicillin-resistant <i>S. aureus</i> and carbapenem-resistant A. baumannii, while 50 mg/L suppressed carbapenem-resistant <i>K. pneumoniae, E. coli</i>, and VIM-positive <i>P. aeruginosa</i>. Carbapenemase-negative <i>P. aeruginosa</i> required 200 mg/L for inhibition. These findings indicate that eravacycline exhibits strain-dependent antibacterial activity in hypothermic preservation solution, with 50 mg/L being effective against most tested multidrug-resistant organisms except carbapenemase-negative <i>P. aeruginosa</i>. Further clinical studies are warranted to evaluate its potential application in transplantation settings.