Safety and Efficacy Study of Cefepime/VNRX-5133 in Patients With Complicated Urinary Tract Infections
- Conditions
- Acute PyelonephritisUrinary Tract Infections
- Interventions
- Drug: Cefepime/VNRX-5133 (taniborbactam)
- Registration Number
- NCT03840148
- Lead Sponsor
- Venatorx Pharmaceuticals, Inc.
- Brief Summary
This study will assess the safety and efficacy of cefepime/VNRX-5133 compared with meropenem in both eradication of bacteria and in symptomatic response in patients with cUTIs.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 661
- Adult male and female
- Documented diagnosis of pyuria
- Documented diagnosis of cUTI or Acute Pyelonephritis (AP)
- Receipt of effective antibacterial drug therapy for cUTI for more than 24 hours during the previous 72 hours prior to randomization
- A urine culture result is resistant to meropenem or a gram negative pathogen is not identified or more than 2 microorganisms are isolated or a confirmed fungal UTI is identified
- Required use of nonstudy systemic bacterial therapy
- Suspected or confirmed prostatitis or urinary tract symptoms attributable to sexually transmitted disease
- Patients with perinephric or renal abscess
- Patients with renal transplantation or receiving hemodialysis or peritoneal dialysis
- Abnormal labs
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Cefepime/VNRX-5133 (taniborbactam) Cefepime/VNRX-5133 (taniborbactam) Cefepime/VNRX-5133 administered q8h intravenously (IV) over a 2-hour period. Meropenem Meropenem Meropenem will be administered q8h IV over 30 minutes.
- Primary Outcome Measures
Name Time Method Composite Success at Test of Cure (TOC) in the Microbiological Intent-to-treat (microITT) Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
- Secondary Outcome Measures
Name Time Method Composite Success at Test of Cure (TOC) in the ME Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Symptomatic clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Composite Success at Late Follow Up (LFU) in the ME Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Symptomatic clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Microbiologic Success at Late Follow Up (LFU) in the ME Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL.
Clinical Success at Late Follow Up (LFU) in the CE Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Symptomatic clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Composite Success at Test of Cure (TOC) in the Extended Microbiological Intent-to-treat (emicroITT) Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Symptomatic clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Composite Success at Late Follow Up (LFU) in the microITT Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Clinical Success at Late Follow Up (LFU) in the microITT Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Microbiologic Success in Patients With Cefepime-Resistant Pathogens at Test of Cure (TOC) in the microITT Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL.
Microbiologic Success in Patients With Cefepime-Resistant Pathogens at Late Follow Up (LFU) in the microITT Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL.
Microbiologic Success at Test of Cure (TOC) in the microITT Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL.
Clinical Success at Test of Cure (TOC) in the microITT Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Composite Success at End of Treatment (EOT) in the microITT Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Microbiological Success at End of Treatment (EOT) in the microITT Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL.
Microbiological Success at Late Follow Up (LFU) in the microITT Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL.
Clinical Success at End of Treatment (EOT) in the microITT Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Investigator Opinion of Clinical Success at Test of Cure (TOC) in the microITT Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) The proportion of patients with clinical success based on investigator opinion at TOC.
Composite Success in Patients With Cefepime-Resistant Pathogens at End of Treatment (EOT) in the microITT Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Microbiologic Success in Patients With Cefepime-Resistant Pathogens at End of Treatment (EOT) in the microITT Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL.
Clinical Success in Patients With Cefepime-Resistant Pathogens at End of Treatment (EOT) in the microITT Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Composite Success in Patients With Cefepime-Resistant Pathogens at Test of Cure (TOC) in the microITT Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Clinical Success in Patients With Cefepime-Resistant Pathogens at Test of Cure (TOC) in the microITT Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Composite Success in Patients With Cefepime-Resistant Pathogens at Late Follow Up (LFU) in the microITT Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Clinical Success in Patients With Cefepime-Resistant Pathogens at Late Follow Up (LFU) in the microITT Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Composite Success at End of Treatment (EOT) in the Microbiologically-Evaluable (ME) Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Microbiologic Success at End of Treatment (EOT) in the ME Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL.
Clinical Success in Patients With Cefepime-Resistant Pathogens at Test of Cure (TOC) in the CE Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Symptomatic clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Per-Pathogen Microbiologic Eradication at End of Treatment (EOT) in the microITT Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Per-pathogen eradication by baseline gram-negative pathogens. The number analyzed corresponds to the number of specified pathogens. The number is the percent of the specified pathogen identified at baseline in each treatment group that had been eradicated.
Microbiologic Success at Test of Cure (TOC) in the ME Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL.
Composite Success in Patients With Cefepime-Resistant Pathogens at the End of Treatment (EOT) in the ME Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Symptomatic clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Microbiologic Success in Patients With Cefepime-Resistant Pathogens at the End of Treatment (EOT) in the ME Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL.
Composite Success in Patients With Cefepime-Resistant Pathogens at Test of Cure (TOC) in the ME Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Symptomatic clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Microbiologic Success in Patients With Cefepime-Resistant Pathogens at Test of Cure (TOC) in the ME Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL.
Composite Success in Cefepime-Resistant Pathogens at Late Follow Up (LFU) in the ME Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL. Symptomatic clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Microbiologic Success in Cefepime-Resistant Pathogens at Late Follow Up (LFU) in the ME Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Microbiologic success is eradication defined as demonstration that any gram-negative bacterial pathogen found at study entry (≥10\^5 CFU/mL) is eradicated to \<10\^3 CFU/mL.
Clinical Success at End of Treatment (EOT) in the Clinically Evaluable (CE) Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Symptomatic clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Clinical Success at Test of Cure (TOC) in the CE Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Symptomatic clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Clinical Success in Patients With Cefepime-Resistant Pathogens at End of Treatment (EOT) in the CE Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Symptomatic clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Clinical Success in Patients With Cefepime-Resistant Pathogens at Late Follow Up (LFU) in the CE Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Symptomatic clinical success is defined as symptomatic resolution or return to pre-morbid baseline of all UTI-core symptoms and patient is alive, and patient has not received additional antibacterial therapy for cUTI.
Per-Pathogen Microbiologic Eradication in Patients With Cefepime-Resistant Pathogens at Test of Cure TOC in the ME Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Per-pathogen eradication by baseline gram-negative pathogens (only pathogens identified 10 or more times are reported). The number analyzed corresponds to the number of specified pathogens. The number is the percent of the specified pathogen identified at baseline in each treatment group that had been eradicated.
Per-Pathogen Microbiologic Eradication in Patients With Cefepime-Resistant Pathogens at Late Follow Up (LFU) in the ME Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Per-pathogen eradication by baseline gram-negative pathogens (only pathogens identified 10 or more times are reported). The number analyzed corresponds to the number of specified pathogens. The number is the percent of the specified pathogen identified at baseline in each treatment group that had been eradicated.
Per-Pathogen Microbiologic Eradication at Test of Cure (TOC) in the microITT Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Per-pathogen eradication by baseline gram-negative pathogens. The number analyzed corresponds to the number of specified pathogens. The number is the percent of the specified pathogen identified at baseline in each treatment group that had been eradicated.
Per-Pathogen Microbiologic Eradication at Late Follow Up (LFU) in the microITT Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Per-pathogen eradication by baseline gram-negative pathogens. The number analyzed corresponds to the number of specified pathogens. The number is the percent of the specified pathogen identified at baseline in each treatment group that had been eradicated.
Per-Pathogen Microbiologic Eradication in Patients With Cefepime-Resistant Pathogens at End of Treatment (EOT) in the microITT Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Per-pathogen eradication by baseline gram-negative pathogens (only pathogens identified 10 or more times are reported). The number analyzed corresponds to the number of specified pathogens. The number is the percent of the specified pathogen identified at baseline in each treatment group that had been eradicated.
Per-Pathogen Microbiologic Eradication in Patients With Cefepime-Resistant Pathogens at Test of Cure (TOC) in the microITT Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Per-pathogen eradication by baseline gram-negative pathogens (only pathogens identified 10 or more times are reported). The number analyzed corresponds to the number of specified pathogens. The number is the percent of the specified pathogen identified at baseline in each treatment group that had been eradicated.
Per-Pathogen Microbiologic Eradication in Patients With Cefepime-Resistant Pathogens at Late Follow Up (LFU) in the microITT Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Per-pathogen eradication by baseline gram-negative pathogens (only pathogens identified 10 or more times are reported). The number analyzed corresponds to the number of specified pathogens. The number is the percent of the specified pathogen identified at baseline in each treatment group that had been eradicated.
Per-Pathogen Microbiologic Eradication at End of Treatment (EOT) in the ME Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Per-pathogen eradication by baseline gram-negative pathogens. The number analyzed corresponds to the number of specified pathogens. The number is the percent of the specified pathogen identified at baseline in each treatment group that had been eradicated.
Per-Pathogen Microbiologic Eradication at Test of Cure (TOC) in the ME Population Assessed at Test of Cure visit (occurred once per participant between Study Days 19 to 23) Per-pathogen eradication by baseline gram-negative pathogens. The number analyzed corresponds to the number of specified pathogens. The number is the percent of the specified pathogen identified at baseline in each treatment group that had been eradicated.
Per-Pathogen Microbiologic Eradication at Late Follow Up (LFU) in the ME Population Assessed at Late Follow Up visit (occurred once per participant between Study Days 28 to 35) Per-pathogen eradication by baseline gram-negative pathogens. The number analyzed corresponds to the number of specified pathogens. The number is the percent of the specified pathogen identified at baseline in each treatment group that had been eradicated.
Per-Pathogen Microbiologic Eradication in Patients With Cefepime-Resistant Pathogens at End of Treatment (EOT) in the ME Population Assessed within 24 hours after last IV dose (up to 15 days from start of treatment) Per-pathogen eradication by baseline gram-negative pathogens (only pathogens identified 10 or more times are reported). The number analyzed corresponds to the number of specified pathogens. The number is the percent of the specified pathogen identified at baseline in each treatment group that had been eradicated.
Trial Locations
- Locations (78)
Site 184001
🇺🇸La Mesa, California, United States
Site 184002
🇺🇸Chula Vista, California, United States
Site 110003
🇧🇬Ruse, Bulgaria
Site 110004
🇧🇬Sofia, Bulgaria
Site 110005
🇧🇬Sofia, Bulgaria
Site 110007
🇧🇬Plovdiv, Bulgaria
Site 156015
🇨🇳Chendu, China
Site 156002
🇨🇳Beijing, China
Site 156004
🇨🇳Dalian, China
Site 156025
🇨🇳Guangzhou, China
Site 156006
🇨🇳Beijing, China
Site 156003
🇨🇳Nanchang, China
Site 134801
🇭🇺Budapest, Hungary
Site 156010
🇨🇳Xiamen, China
Site 142803
🇱🇻Daugavpils, Latvia
Site 148401
🇲🇽Guadalajara, Mexico
Site 164308
🇷🇺Pyatigorsk, Russian Federation
Site 164302
🇷🇺Saratov, Russian Federation
Site 189001
🇷🇸Belgrade, Serbia
Site 134804
🇭🇺Szeged, Hungary
Site 160406
🇵🇪Lima, Peru
Site 160403
🇵🇪Cuzco, Peru
Site 164311
🇷🇺Rostov-on-Don, Russian Federation
Site 179205
🇹🇷Çankaya, Turkey
Site 179207
🇹🇷Adapazarı, Turkey
Site 180403
🇺🇦Vinnytsia, Ukraine
Site 180407
🇺🇦Zaporizhzhya, Ukraine
Site 184003
🇺🇸Buena Park, California, United States
184012
🇺🇸Northridge, California, United States
Site 103203
🇦🇷Córdoba, Argentina
Site 156014
🇨🇳Guangdong, China
Site 119106
🇭🇷Zagreb, Croatia
Site 164206
🇷🇴Bucuresti, Romania
Site 164201
🇷🇴Craiova, Romania
Site 164301
🇷🇺Penza, Russian Federation
Site 164303
🇷🇺Sankt Peterburg, Russian Federation
Site 179203
🇹🇷Bornova, Turkey
Site 179204
🇹🇷Diyarbakır, Turkey
Site 180406
🇺🇦Kyiv, Ukraine
Site 180401
🇺🇦Luts'k, Ukraine
Site 156005
🇨🇳Nanjing, China
Site 110010
🇧🇬Sofia, Bulgaria
Site 156029
🇨🇳Ürümqi, China
Site 119101
🇭🇷Zagreb, Croatia
Site 134803
🇭🇺Nyiregyhaza, Hungary
Site 148402
🇲🇽Colima, Mexico
Site 107601
🇧🇷Belo Horizonte, Brazil
Site 107608
🇧🇷San Paolo, Brazil
Site 110009
🇧🇬Gabrovo, Bulgaria
Site 156012
🇨🇳Chongqing, China
Site 156027
🇨🇳Guangdong, China
Site 119103
🇭🇷Split, Croatia
Site 160410
🇵🇪Lima, Peru
Site 160404
🇵🇪Trujillo, Peru
Site 179202
🇹🇷Bostanci, Turkey
Site 156018
🇨🇳Guiyang, China
Site 156022
🇨🇳Baotou, China
Site 156011
🇨🇳Chongqing, China
Site 156013
🇨🇳Ningbo, China
Site 189002
🇷🇸Belgrade, Serbia
Site 110002
🇧🇬Pleven, Bulgaria
Site 110008
🇧🇬Sofia, Bulgaria
Site 110001
🇧🇬Veliko Tarnovo, Bulgaria
Site 156030
🇨🇳Fujian, China
Site 156028
🇨🇳Shandong, China
Site 156017
🇨🇳Shanghai, China
Site 156016
🇨🇳Shijiazhuang, China
Site 156020
🇨🇳Tianjin, China
Site 142804
🇱🇻Riga, Latvia
Site 142801
🇱🇻Riga, Latvia
Site 164205
🇷🇴Bucuresti, Romania
Site 180404
🇺🇦Dnipro, Ukraine
Site 180408
🇺🇦Ivano-Frankivs'k, Ukraine
Site 164307
🇷🇺Moscow, Russian Federation
Site 164204
🇷🇴Bucharest, Romania
Site 180402
🇺🇦Kharkiv, Ukraine
Site 156008
🇨🇳Nanjing, China
Site 156007
🇨🇳Nanjing, China