Article

Tigecycline susceptibility report from an Indian tertiary care hospital

Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, New Delhi, India.
The Indian Journal of Medical Research (Impact Factor: 1.66). 04/2009; 129(4):446-50.
Source: PubMed

ABSTRACT Treatment of serious life threatening infections due to multi-drug resistant pathogens presents a difficult challenge due to the limited therapeutic options. Therefore, we studied the in vitro susceptibility of tigecycline, a new glycylcycline with promising broad spectrum of activity against Gram positive and Gram negative bacteria at a tertiary care hospital in north India.
A total of 75 multi-drug resistant isolates of methicillin resistant Staphylococcus aureus (21), vancomycin resistant enterococci (14), vancomycin resistant Streptococcus spp. (3), extended spectrum beta lactamase producing Gram negative bacteria (11) and multi-resistant Acinetobacter spp. (26) were tested for tigecycline susceptibility by the E-test and disc diffusion methods. An additional 83 multi-resistant Gram negative clinical isolates were screened by disc diffusion method alone.
All the isolates of MRSA, VRE, vancomycin resistant Streptococcus spp. and ESBL producing enteric bacteria were sensitive to tigecycline by the E-test and disc diffusion methods. However, only 42 per cent of Acinetobacter spp. were found to be sensitive to tigecycline by the E-test method.
In conclusion, tigecycline was found to be highly effective against Gram-positive bacteria and Gram-negative members of Enterobacteriaceae, but a high prevalence of resistance in members of Acinetobacter spp. is worrisome.

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    • "infections due to efflux pump have been reported [27]. A study conducted by Behera et al. (2009) [28], showed that all K. pneumoniae and E. coli were susceptible to tigecycline; on the other hand 58% of A. baumannii were resistant (using the Enterobacteriaceae breakpoint). In our study, even the A. baumannii isolates that harbored adeB gene were susceptible to tigecycline. "
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    ABSTRACT: Background: The aim of this study was to evaluate the in vitro susceptibility of MDR gram-negatives bacteria to old drugs such as polymyxin B, minocycline and fosfomycin and new drugs such as tigecycline. Methods: One hundred and fifty-three isolates from 4 Brazilian hospitals were evaluated. Forty-seven Acinetobacter baumannii resistant to carbapenens harboring adeB, bla(OxA23), bla(OxA51), bla(OxA143) 23, and bla(IMP) genes, 48 Stenotrophomonas maltophilia including isolates resistant to levofloxacin and/or trimethoprim-sulfamethoxazole harboring sul-1, sul-2 and qnr(MR) and 8 Serratia marcescens and 50 Klebsiella pneumoniae resistant to carbapenens harboring bla(KPC-2) were tested to determine their minimum inhibitory concentrations (MICs) by microdilution to the following drugs: minocycline, ampicillin-sulbactam, tigecycline, and polymyxin B and by agar dilution to fosfomycin according with breakpoint criteria of CLSI and EUCAST (fosfomycin). In addition, EUCAST fosfomycin breakpoint for Pseudomonas spp. was applied for Acinetobacter spp and S. maltophilia, the FDA criteria for tigecycline was used for Acinetobacter spp and S. maltophilia and the Pseudomonas spp polymyxin B CLSI criterion was used for S. maltophilia. Results: Tigecycline showed the best in vitro activity against the MDR gram-negative evaluated, followed by polymyxin B and fosfomycin. Polymyxin B resistance among K. pneumoniae was detected in 6 isolates, using the breakpoint of MIC > 8 ug/mL. Two of these isolates were resistant to tigecycline. Minocycline was tested only against S. maltophilia and A. baumannii and showed excellent activity against both. Conclusions: Fosfomycin seems to not be an option to treat infections due to the A. baumannii and S. maltophilia isolates according with EUCAST breakpoint, on the other hand, showed excellent activity against S. marcescens and K. pneumoniae.
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    • "Susceptibility of these organisms to tigecycline was determined using 15µg tigecycline disc (BBL TM BD,USA). The criteria of the United States, Food and Drug Administration, was used for interpretation [11]. "
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    • "In the study isolates tigecycline demonstrated good activity against the Acinetobacter baumannii with MIC ≤2µ/ml in 80% (n=20) and in the remaining 20% (n=5) the MIC was in intermediate range (4µ/ml). A tigecycline susceptibility report from a tertiary care hospital in India reported a low rate of susceptibility (42%) to tigecycline among Acinetobacter species, where the organisms were totally unexposed to tigecycline and also to the tetracycline group of antibiotics [2]. In another study from India, 70.6% of MDR Acinetobacter species were susceptible to tigecycline [11]. "
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    ABSTRACT: Background: Resistance to multiple anti-microbial agents among gram positive and gram negative pathogens is high worldwide. Tigecycline, a glycylcycline antibiotic is a promising advancement in the treatment of infections caused by multidrug resistant organisms.
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