Susceptibility of common aerobic pathogens to tigecycline: results of a surveillance study in Germany

Abstract

Tigecycline is a novel antimicrobial agent for parenteral use encompassing a broad spectrum of bacterial pathogens, including multi-resistant organisms. Here, we report the results of the first nationwide surveillance trial that was conducted in order to evaluate the susceptibility of bacterial isolates to tigecycline in a European country prior to its clinical use. A total of 2,610 Gram-positive and Gram-negative organisms recovered from hospitalized patients were tested. Minimum inhibitory concentrations (MICs) were determined using the microdilution method. All enterococci, staphylococci (including methicillin-resistant Staphylococcus aureus; MRSA), and streptococci tested were tigecycline-susceptible, except one isolate of Staphylococcus haemolyticus. Among the Gram-negative bacteria, 100% of the Escherichia coli isolates (including extended spectrum beta-lactamase [ESBL]-producers) were tigecycline-susceptible, while about 10% of the Enterobacter cloacae and Klebsiella pneumoniae isolates were resistant. Based on the results of this surveillance study, tigecycline may represent a suitable option most notably for the empiric treatment of bacterial mixed infections, including in clinical situations in which multi-resistant organisms are suspected.

Prospective, Non-Interventional, Multi-Centre Trial of Tigecycline in the Treatment of Severely Ill Patients with Complicated Infections – New Insights into Clinical Results and Treatment Practice

“…The low susceptibility of P. aeruginosa in this non-interventional study is in line with previous results [30,31] confirming that tigecycline does not have reliable in vitro activity against this pathogen. The favourable results on the susceptibility of the other pathogens to tigecycline are consistent with the experience gathered in the German Tigecycline Evaluation Surveillance Trial [14,15]. In this nationwide two-phase multi-centre surveillance study, the susceptibility of bacterial isolates from hospitalized patients with community- or hospital-acquired infections was evaluated before and 1 year after the introduction of tigecycline into clinical use.…”

“…Designed to circumvent the common drug resistance mechanisms of efflux and ribosomal protection, tigecycline is active in vitro against antibiotic-resistant bacteria such as VRE (E. faecalis and E. faecium), methicillin-resistant S. aureus, ESBL-producing enteric Gram-negative bacteria, as well as isolates of the A. baumannii group [13,14,15]. …”

Susceptibility of clinical methicillin-resistant Staphylococci isolates to new antibiotics

“…There have been two studies reporting that tigecyclineresistant staphylococcus strains were found. In one, among a total of 2610 species (Gram-positive and Gram-negative), one S. haemolyticus was found to be resistant to tigecycline [23]. In the other study, tigecycline resistance was detected in 1.8% of the 1989 community-acquired MRSA strains [27].…”

Antimicrobial Resistance and Virulence: a Successful or Deleterious Association in the Bacterial World?

“…Mechanisms of tigecycline resistance, such as the RND efflux system, also provide resistance to tetracyclines. Although tigecycline remains more active than other antimicrobials usually tested against MDR pathogens (e.g., fluoroquinolones and ␤-lactams), several tigecyclineresistant strains have been described in recent years (146).…”