Superinfection during treatment of nosocomial infections with tigecycline

Abstract

We performed a retrospective and observational study of 51 patients treated with tigecycline, as the treatment for nosocomial infections due to multidrugresistant microorganisms, to evaluate the superinfection rate and their etiologies. Superinfections were diagnosed in 12 (23.5%) patients (seven due to Pseudomonas aeruginosa, 13.7%) and one patient had P. aeruginosa colonization. Five patients with superinfection died (41.6%), three due to superinfections and two to underlying diseases. The superinfection rate observed during tigecycline treatment is higher than that previously reported. Pseudomonas aeruginosa is the most frequent agent, being the cause of 58.5% of all superinfections.

Increasing frequency of Pseudomonas aeruginosa infections during tigecycline use

“…The problem arising with widespread use of tigecycline is the emergence of increased rates of PA infection, or infections by other microorganisms with reduced susceptibility to this antibiotic. A recent study indicates that the risk of superinfection rates, particularly on account of PA, increased during tigecycline therapy [9]. The authors reported PA superinfection in 13.7% of 51 patients, a higher rate than previously reported [10,11].…”

Outcomes in patients infected with carbapenem-resistant Acinetobacter baumannii and treated with tigecycline alone or in combination therapy

“…In a recent retrospective study of 51 patients treated with tigecycline for nosocomial infections due to MDR microorganisms, superinfection was diagnosed in 23.5% of patients. P. aeruginosa was the most frequent pathogen as in our study [17]. In another retrospective study, superinfection was detected in 7 of 21 patients and the isolated pathogens were E. aerogenes, K. pneumoniae, and P. aeruginosa [15].…”

Microbial isolation and emergence of antimicrobial resistance associated with tigecycline usage

“…However, there was no increase in the isolation rate of P aeruginosa in our study, although it ranked the first among the most frequent pathogens in hospital-acquired infections and was responsible for 12.4% (148/1186) of the cases reported in the study hospital in 2009 (Data from Infection Control Committee). Unlike in a previous study, 17 in this study, we included not only cases of nosocomial infection. Besides, many cases in the study received antipseudomonal antibiotics before tigecycline treatment.…”

“…The superinfection rate with tigecycline usage ranged from 2.4% to 23.5% across different studies. 17,18 GarciaCabrera et al 17 had reported that P. aeruginosa caused 58.5% superinfections at an average of 8 days of tigecycline treatment for nosocomial infections. Five cases (7.5%) in the study had bacterial isolation other than those causing their primary infections.…”