SK4122002A3 - 7-Acylamino-3-heteroarylthio-3-cephem carboxylic acid antibiotics and prodrugs thereof - Google Patents

Info

Publication number

SK4122002A3

SK4122002A3 SK412-2002A SK4122002A SK4122002A3 SK 4122002 A3 SK4122002 A3 SK 4122002A3 SK 4122002 A SK4122002 A SK 4122002A SK 4122002 A3 SK4122002 A3 SK 4122002A3

Authority

SK

Slovakia

Prior art keywords

cephem

amino

carboxylic acid

acetamido

ylthio

Prior art date

1999-09-22

Links

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• 239000000651 prodrug Substances 0.000 title abstract description 26
• 229940002612 prodrug Drugs 0.000 title abstract description 26
• 239000003242 anti bacterial agent Substances 0.000 title abstract description 13
• 239000002253 acid Substances 0.000 title description 19
• 229940088710 antibiotic agent Drugs 0.000 title description 12
• 150000001875 compounds Chemical class 0.000 claims abstract description 294
• 150000003839 salts Chemical class 0.000 claims abstract description 48
• -1 2-amino-5-chlorothiazol-4-yl Chemical group 0.000 claims description 640
• 125000000738 acetamido group Chemical group [H]C([H])([H])C(=O)N([H])[*] 0.000 claims description 192
• 239000000203 mixture Substances 0.000 claims description 96
• 125000001424 substituent group Chemical group 0.000 claims description 70
• IJGRMHOSHXDMSA-UHFFFAOYSA-N nitrogen Substances N#N IJGRMHOSHXDMSA-UHFFFAOYSA-N 0.000 claims description 52
• 229910052757 nitrogen Inorganic materials 0.000 claims description 45
• 229910052739 hydrogen Inorganic materials 0.000 claims description 42
• 239000001257 hydrogen Substances 0.000 claims description 39
• 125000000217 alkyl group Chemical group 0.000 claims description 38
• 125000004435 hydrogen atom Chemical group [H]* 0.000 claims description 34
• 241000894006 Bacteria Species 0.000 claims description 28
• 125000000999 tert-butyl group Chemical group [H]C([H])([H])C(*)(C([H])([H])[H])C([H])([H])[H] 0.000 claims description 25
• JUJWROOIHBZHMG-UHFFFAOYSA-N Pyridine Chemical compound C1=CC=NC=C1 JUJWROOIHBZHMG-UHFFFAOYSA-N 0.000 claims description 24
• 125000003178 carboxy group Chemical group [H]OC(*)=O 0.000 claims description 22
• ZZVUWRFHKOJYTH-UHFFFAOYSA-N diphenhydramine Chemical group C=1C=CC=CC=1C(OCCN(C)C)C1=CC=CC=C1 ZZVUWRFHKOJYTH-UHFFFAOYSA-N 0.000 claims description 17
• 125000003903 2-propenyl group Chemical group [H]C([*])([H])C([H])=C([H])[H] 0.000 claims description 16
• 125000001797 benzyl group Chemical group [H]C1=C([H])C([H])=C(C([H])=C1[H])C([H])([H])* 0.000 claims description 16
• 239000000460 chlorine Chemical group 0.000 claims description 16
• 125000004432 carbon atom Chemical group C* 0.000 claims description 15
• 125000002496 methyl group Chemical group [H]C([H])([H])* 0.000 claims description 15
• 241000124008 Mammalia Species 0.000 claims description 14
• 229960003085 meticillin Drugs 0.000 claims description 14
• RJQXTJLFIWVMTO-TYNCELHUSA-N Methicillin Chemical compound COC1=CC=CC(OC)=C1C(=O)N[C@@H]1C(=O)N2[C@@H](C(O)=O)C(C)(C)S[C@@H]21 RJQXTJLFIWVMTO-TYNCELHUSA-N 0.000 claims description 13
• 229910052801 chlorine Chemical group 0.000 claims description 13
• ZAMOUSCENKQFHK-UHFFFAOYSA-N Chlorine atom Chemical group [Cl] ZAMOUSCENKQFHK-UHFFFAOYSA-N 0.000 claims description 12
• UFHFLCQGNIYNRP-UHFFFAOYSA-N Hydrogen Chemical compound [H][H] UFHFLCQGNIYNRP-UHFFFAOYSA-N 0.000 claims description 12
• UMJSCPRVCHMLSP-UHFFFAOYSA-N pyridine Natural products COC1=CC=CN=C1 UMJSCPRVCHMLSP-UHFFFAOYSA-N 0.000 claims description 12
• 229910052799 carbon Inorganic materials 0.000 claims description 10
• 125000002221 trityl group Chemical group [H]C1=C([H])C([H])=C([H])C([H])=C1C([*])(C1=C(C(=C(C(=C1[H])[H])[H])[H])[H])C1=C([H])C([H])=C([H])C([H])=C1[H] 0.000 claims description 10
• 230000000844 anti-bacterial effect Effects 0.000 claims description 9
• 125000000453 2,2,2-trichloroethyl group Chemical group [H]C([H])(*)C(Cl)(Cl)Cl 0.000 claims description 8
• 125000002103 4,4'-dimethoxytriphenylmethyl group Chemical group [H]C1=C([H])C([H])=C(C([H])=C1[H])C(*)(C1=C([H])C([H])=C(OC([H])([H])[H])C([H])=C1[H])C1=C([H])C([H])=C(OC([H])([H])[H])C([H])=C1[H] 0.000 claims description 8
• 125000004184 methoxymethyl group Chemical group [H]C([H])([H])OC([H])([H])* 0.000 claims description 8
• 125000006503 p-nitrobenzyl group Chemical group [H]C1=C([H])C(=C([H])C([H])=C1[N+]([O-])=O)C([H])([H])* 0.000 claims description 8
• 125000000547 substituted alkyl group Chemical group 0.000 claims description 8
• 125000000026 trimethylsilyl group Chemical group [H]C([H])([H])[Si]([*])(C([H])([H])[H])C([H])([H])[H] 0.000 claims description 8
• 125000002927 2-methoxybenzyl group Chemical group [H]C1=C([H])C([H])=C(C(OC([H])([H])[H])=C1[H])C([H])([H])* 0.000 claims description 7
• 125000002774 3,4-dimethoxybenzyl group Chemical group [H]C1=C([H])C(=C([H])C(OC([H])([H])[H])=C1OC([H])([H])[H])C([H])([H])* 0.000 claims description 7
• 125000002252 acyl group Chemical group 0.000 claims description 7
• 125000001160 methoxycarbonyl group Chemical group [H]C([H])([H])OC(*)=O 0.000 claims description 7
• 125000001981 tert-butyldimethylsilyl group Chemical group [H]C([H])([H])[Si]([H])(C([H])([H])[H])[*]C(C([H])([H])[H])(C([H])([H])[H])C([H])([H])[H] 0.000 claims description 7
• 125000004217 4-methoxybenzyl group Chemical group [H]C1=C([H])C(=C([H])C([H])=C1OC([H])([H])[H])C([H])([H])* 0.000 claims description 6
• 108090000790 Enzymes Proteins 0.000 claims description 6
• 102000004190 Enzymes Human genes 0.000 claims description 6
• 125000001997 phenyl group Chemical group [H]C1=C([H])C([H])=C(*)C([H])=C1[H] 0.000 claims description 6
• 239000003937 drug carrier Substances 0.000 claims description 4
• 125000004433 nitrogen atom Chemical group N* 0.000 claims description 4
• QJGQUHMNIGDVPM-UHFFFAOYSA-N nitrogen group Chemical group [N] QJGQUHMNIGDVPM-UHFFFAOYSA-N 0.000 claims description 4
• LHBXOUDOBYWKFJ-XXWSSQRBSA-N (6R,7R)-7-[[(2Z)-2-(2-amino-5-chloro-1,3-thiazol-4-yl)-2-hydroxyiminoacetyl]amino]-3-[2-[2-(diaminomethylideneamino)ethylsulfanylmethyl]pyridin-3-yl]sulfanyl-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid Chemical compound NC=1SC(=C(N=1)/C(/C(=O)N[C@H]1[C@@H]2N(C(=C(CS2)SC=2C(=NC=CC=2)CSCCNC(=N)N)C(=O)O)C1=O)=N/O)Cl LHBXOUDOBYWKFJ-XXWSSQRBSA-N 0.000 claims description 3
• KLSJWNVTNUYHDU-UHFFFAOYSA-N Amitrole Chemical compound NC1=NC=NN1 KLSJWNVTNUYHDU-UHFFFAOYSA-N 0.000 claims description 3
• 241000344863 Staphylococcus aureus subsp. aureus COL Species 0.000 claims description 3
• 241000191984 Staphylococcus haemolyticus Species 0.000 claims description 3
• YMBOKCFFCGMUBS-VFYRPSQSSA-N NC1=NC(=CC=C1)/C(/C(=O)N[C@H]1[C@@H]2N(C(=C(CS2)SC=2C=NC=CC=2CSCCN)C(=O)O)C1=O)=N/O Chemical compound NC1=NC(=CC=C1)/C(/C(=O)N[C@H]1[C@@H]2N(C(=C(CS2)SC=2C=NC=CC=2CSCCN)C(=O)O)C1=O)=N/O YMBOKCFFCGMUBS-VFYRPSQSSA-N 0.000 claims description 2
• 206010041925 Staphylococcal infections Diseases 0.000 claims description 2
• 150000002431 hydrogen Chemical group 0.000 claims 4
• 125000000896 monocarboxylic acid group Chemical group 0.000 claims 2
• SCSMAWFISUMSTO-ZTJYIHJESA-N (6R,7R)-3-[2-(2-aminoethylsulfanylmethyl)pyridin-3-yl]sulfanyl-7-[[(2Z)-2-(5-amino-1,2,4-thiadiazol-3-yl)-2-hydroxyiminoacetyl]amino]-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid Chemical compound NC1=NC(=NS1)/C(/C(=O)N[C@H]1[C@@H]2N(C(=C(CS2)SC=2C(=NC=CC=2)CSCCN)C(=O)O)C1=O)=N/O SCSMAWFISUMSTO-ZTJYIHJESA-N 0.000 claims 1
• SBUOHGKIOVRDKY-UHFFFAOYSA-N 4-methyl-1,3-dioxolane Chemical compound CC1COCO1 SBUOHGKIOVRDKY-UHFFFAOYSA-N 0.000 claims 1
• SWQWTDAWUSBMGA-UHFFFAOYSA-N 5-chloro-1,3-thiazol-2-amine Chemical compound NC1=NC=C(Cl)S1 SWQWTDAWUSBMGA-UHFFFAOYSA-N 0.000 claims 1
• 238000000034 method Methods 0.000 abstract description 46
• 239000003782 beta lactam antibiotic agent Substances 0.000 abstract description 15
• 239000002132 β-lactam antibiotic Substances 0.000 abstract description 14
• 229940124586 β-lactam antibiotics Drugs 0.000 abstract description 14
• 230000003115 biocidal effect Effects 0.000 abstract description 4
• 239000000543 intermediate Substances 0.000 abstract description 4
• 238000001228 spectrum Methods 0.000 abstract 1
• XEKOWRVHYACXOJ-UHFFFAOYSA-N Ethyl acetate Chemical compound CCOC(C)=O XEKOWRVHYACXOJ-UHFFFAOYSA-N 0.000 description 389
• 239000000243 solution Substances 0.000 description 227
• YMWUJEATGCHHMB-UHFFFAOYSA-N Dichloromethane Chemical compound ClCCl YMWUJEATGCHHMB-UHFFFAOYSA-N 0.000 description 219
• OKKJLVBELUTLKV-UHFFFAOYSA-N Methanol Chemical compound OC OKKJLVBELUTLKV-UHFFFAOYSA-N 0.000 description 207
• XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 150
• 235000019439 ethyl acetate Nutrition 0.000 description 129
• ZMXDDKWLCZADIW-UHFFFAOYSA-N N,N-Dimethylformamide Chemical compound CN(C)C=O ZMXDDKWLCZADIW-UHFFFAOYSA-N 0.000 description 128
• 239000011541 reaction mixture Substances 0.000 description 115
• 238000005481 NMR spectroscopy Methods 0.000 description 107
• DTQVDTLACAAQTR-UHFFFAOYSA-N Trifluoroacetic acid Chemical compound OC(=O)C(F)(F)F DTQVDTLACAAQTR-UHFFFAOYSA-N 0.000 description 97
• RTZKZFJDLAIYFH-UHFFFAOYSA-N Diethyl ether Chemical compound CCOCC RTZKZFJDLAIYFH-UHFFFAOYSA-N 0.000 description 67
• PMZURENOXWZQFD-UHFFFAOYSA-L Sodium Sulfate Chemical compound [Na+].[Na+].[O-]S([O-])(=O)=O PMZURENOXWZQFD-UHFFFAOYSA-L 0.000 description 64
• VLKZOEOYAKHREP-UHFFFAOYSA-N n-Hexane Chemical compound CCCCCC VLKZOEOYAKHREP-UHFFFAOYSA-N 0.000 description 58
• VEXZGXHMUGYJMC-UHFFFAOYSA-N Hydrochloric acid Chemical compound Cl VEXZGXHMUGYJMC-UHFFFAOYSA-N 0.000 description 57
• 238000006243 chemical reaction Methods 0.000 description 56
• 239000007787 solid Substances 0.000 description 55
• 239000012074 organic phase Substances 0.000 description 52
• 210000002966 serum Anatomy 0.000 description 52
• WEVYAHXRMPXWCK-UHFFFAOYSA-N Acetonitrile Chemical compound CC#N WEVYAHXRMPXWCK-UHFFFAOYSA-N 0.000 description 51
• UIIMBOGNXHQVGW-UHFFFAOYSA-M Sodium bicarbonate Chemical compound [Na+].OC([O-])=O UIIMBOGNXHQVGW-UHFFFAOYSA-M 0.000 description 50
• 229910052938 sodium sulfate Inorganic materials 0.000 description 50
• 235000011152 sodium sulphate Nutrition 0.000 description 50
• WYURNTSHIVDZCO-UHFFFAOYSA-N Tetrahydrofuran Chemical compound C1CCOC1 WYURNTSHIVDZCO-UHFFFAOYSA-N 0.000 description 46
• 239000002904 solvent Substances 0.000 description 46
• AQRLNPVMDITEJU-UHFFFAOYSA-N triethylsilane Chemical compound CC[SiH](CC)CC AQRLNPVMDITEJU-UHFFFAOYSA-N 0.000 description 46
• VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 description 45
• 239000000741 silica gel Substances 0.000 description 44
• 229910002027 silica gel Inorganic materials 0.000 description 44
• AFVFQIVMOAPDHO-UHFFFAOYSA-N Methanesulfonic acid Chemical compound CS(O)(=O)=O AFVFQIVMOAPDHO-UHFFFAOYSA-N 0.000 description 43
• 230000002829 reductive effect Effects 0.000 description 41
• HEMHJVSKTPXQMS-UHFFFAOYSA-M Sodium hydroxide Chemical compound [OH-].[Na+] HEMHJVSKTPXQMS-UHFFFAOYSA-M 0.000 description 39
• 238000003756 stirring Methods 0.000 description 38
• WQDUMFSSJAZKTM-UHFFFAOYSA-N Sodium methoxide Chemical compound [Na+].[O-]C WQDUMFSSJAZKTM-UHFFFAOYSA-N 0.000 description 35
• 239000012267 brine Substances 0.000 description 35
• HPALAKNZSZLMCH-UHFFFAOYSA-M sodium;chloride;hydrate Chemical compound O.[Na+].[Cl-] HPALAKNZSZLMCH-UHFFFAOYSA-M 0.000 description 35
• ZMANZCXQSJIPKH-UHFFFAOYSA-N Triethylamine Chemical compound CCN(CC)CC ZMANZCXQSJIPKH-UHFFFAOYSA-N 0.000 description 33
• 229930186147 Cephalosporin Natural products 0.000 description 31
• 229940124587 cephalosporin Drugs 0.000 description 31
• 239000000047 product Substances 0.000 description 29
• KWGKDLIKAYFUFQ-UHFFFAOYSA-M lithium chloride Chemical compound [Li+].[Cl-] KWGKDLIKAYFUFQ-UHFFFAOYSA-M 0.000 description 26
• JGFZNNIVVJXRND-UHFFFAOYSA-N N,N-Diisopropylethylamine (DIPEA) Chemical compound CCN(C(C)C)C(C)C JGFZNNIVVJXRND-UHFFFAOYSA-N 0.000 description 25
• 125000000623 heterocyclic group Chemical group 0.000 description 24
• 235000017557 sodium bicarbonate Nutrition 0.000 description 24
• 229910000030 sodium bicarbonate Inorganic materials 0.000 description 24
• 239000000725 suspension Substances 0.000 description 24
• YLQBMQCUIZJEEH-UHFFFAOYSA-N tetrahydrofuran Natural products C=1C=COC=1 YLQBMQCUIZJEEH-UHFFFAOYSA-N 0.000 description 23
• 150000001780 cephalosporins Chemical class 0.000 description 22
• JOXIMZWYDAKGHI-UHFFFAOYSA-N toluene-4-sulfonic acid Chemical compound CC1=CC=C(S(O)(=O)=O)C=C1 JOXIMZWYDAKGHI-UHFFFAOYSA-N 0.000 description 22
• QTBSBXVTEAMEQO-UHFFFAOYSA-N Acetic acid Chemical compound CC(O)=O QTBSBXVTEAMEQO-UHFFFAOYSA-N 0.000 description 21
• OAYLNYINCPYISS-UHFFFAOYSA-N ethyl acetate;hexane Chemical compound CCCCCC.CCOC(C)=O OAYLNYINCPYISS-UHFFFAOYSA-N 0.000 description 20
• 239000000284 extract Substances 0.000 description 20
• 239000012071 phase Substances 0.000 description 20
• 239000002244 precipitate Substances 0.000 description 20
• FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 19
• 125000003118 aryl group Chemical group 0.000 description 19
• 229940098779 methanesulfonic acid Drugs 0.000 description 19
• 238000000746 purification Methods 0.000 description 19
• LFQSCWFLJHTTHZ-UHFFFAOYSA-N Ethanol Chemical compound CCO LFQSCWFLJHTTHZ-UHFFFAOYSA-N 0.000 description 18
• 239000000706 filtrate Substances 0.000 description 18
• GDTBXPJZTBHREO-UHFFFAOYSA-N bromine Substances BrBr GDTBXPJZTBHREO-UHFFFAOYSA-N 0.000 description 17
• 229910052794 bromium Inorganic materials 0.000 description 17
• 208000015181 infectious disease Diseases 0.000 description 16
• AOSZTAHDEDLTLQ-AZKQZHLXSA-N (1S,2S,4R,8S,9S,11S,12R,13S,19S)-6-[(3-chlorophenyl)methyl]-12,19-difluoro-11-hydroxy-8-(2-hydroxyacetyl)-9,13-dimethyl-6-azapentacyclo[10.8.0.02,9.04,8.013,18]icosa-14,17-dien-16-one Chemical compound C([C@@H]1C[C@H]2[C@H]3[C@]([C@]4(C=CC(=O)C=C4[C@@H](F)C3)C)(F)[C@@H](O)C[C@@]2([C@@]1(C1)C(=O)CO)C)N1CC1=CC=CC(Cl)=C1 AOSZTAHDEDLTLQ-AZKQZHLXSA-N 0.000 description 15
• WKBOTKDWSSQWDR-UHFFFAOYSA-N Bromine atom Chemical compound [Br] WKBOTKDWSSQWDR-UHFFFAOYSA-N 0.000 description 15
• 229940126657 Compound 17 Drugs 0.000 description 15
• 241000700159 Rattus Species 0.000 description 15
• 238000004128 high performance liquid chromatography Methods 0.000 description 15
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• 230000001580 bacterial effect Effects 0.000 description 14
• 239000002585 base Substances 0.000 description 14
• 230000015572 biosynthetic process Effects 0.000 description 14
• 230000000694 effects Effects 0.000 description 14
• 125000006239 protecting group Chemical group 0.000 description 14
• RIOQSEWOXXDEQQ-UHFFFAOYSA-N triphenylphosphine Chemical compound C1=CC=CC=C1P(C=1C=CC=CC=1)C1=CC=CC=C1 RIOQSEWOXXDEQQ-UHFFFAOYSA-N 0.000 description 14
• 241000282414 Homo sapiens Species 0.000 description 13
• 125000003342 alkenyl group Chemical group 0.000 description 13
• 125000003545 alkoxy group Chemical group 0.000 description 13
• 238000004587 chromatography analysis Methods 0.000 description 13
• 125000002887 hydroxy group Chemical group [H]O* 0.000 description 13
• BWGNESOTFCXPMA-UHFFFAOYSA-N Dihydrogen disulfide Chemical compound SS BWGNESOTFCXPMA-UHFFFAOYSA-N 0.000 description 12
• KFZMGEQAYNKOFK-UHFFFAOYSA-N Isopropanol Chemical compound CC(C)O KFZMGEQAYNKOFK-UHFFFAOYSA-N 0.000 description 12
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• 125000005931 tert-butyloxycarbonyl group Chemical group [H]C([H])([H])C(OC(*)=O)(C([H])([H])[H])C([H])([H])[H] 0.000 description 12
• 125000003349 3-pyridyl group Chemical group N1=C([H])C([*])=C([H])C([H])=C1[H] 0.000 description 11
• 125000000066 S-methyl group Chemical group [H]C([H])([H])S* 0.000 description 11
• 241000191967 Staphylococcus aureus Species 0.000 description 11
• 125000004414 alkyl thio group Chemical group 0.000 description 11
• 239000012043 crude product Substances 0.000 description 11
• 239000011780 sodium chloride Substances 0.000 description 11
• 239000007858 starting material Substances 0.000 description 11
• 239000000126 substance Substances 0.000 description 11
• 238000003786 synthesis reaction Methods 0.000 description 11
• DYHSDKLCOJIUFX-UHFFFAOYSA-N tert-butoxycarbonyl anhydride Chemical compound CC(C)(C)OC(=O)OC(=O)OC(C)(C)C DYHSDKLCOJIUFX-UHFFFAOYSA-N 0.000 description 11
• HEDRZPFGACZZDS-MICDWDOJSA-N Trichloro(2H)methane Chemical compound [2H]C(Cl)(Cl)Cl HEDRZPFGACZZDS-MICDWDOJSA-N 0.000 description 10
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• 125000004453 alkoxycarbonyl group Chemical group 0.000 description 10
• 238000001816 cooling Methods 0.000 description 10
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• 239000002054 inoculum Substances 0.000 description 10
• ZLVXBBHTMQJRSX-VMGNSXQWSA-N jdtic Chemical compound C1([C@]2(C)CCN(C[C@@H]2C)C[C@H](C(C)C)NC(=O)[C@@H]2NCC3=CC(O)=CC=C3C2)=CC=CC(O)=C1 ZLVXBBHTMQJRSX-VMGNSXQWSA-N 0.000 description 10
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• 125000002924 primary amino group Chemical group [H]N([H])* 0.000 description 9
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• MYPYJXKWCTUITO-UHFFFAOYSA-N vancomycin Natural products O1C(C(=C2)Cl)=CC=C2C(O)C(C(NC(C2=CC(O)=CC(O)=C2C=2C(O)=CC=C3C=2)C(O)=O)=O)NC(=O)C3NC(=O)C2NC(=O)C(CC(N)=O)NC(=O)C(NC(=O)C(CC(C)C)NC)C(O)C(C=C3Cl)=CC=C3OC3=CC2=CC1=C3OC1OC(CO)C(O)C(O)C1OC1CC(C)(N)C(O)C(C)O1 MYPYJXKWCTUITO-UHFFFAOYSA-N 0.000 description 9
• 241000699670 Mus sp. Species 0.000 description 8
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• 229960003165 vancomycin Drugs 0.000 description 8
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• BHIIGRBMZRSDRI-UHFFFAOYSA-N [chloro(phenoxy)phosphoryl]oxybenzene Chemical compound C=1C=CC=CC=1OP(=O)(Cl)OC1=CC=CC=C1 BHIIGRBMZRSDRI-UHFFFAOYSA-N 0.000 description 7
• 208000022362 bacterial infectious disease Diseases 0.000 description 7
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