In vitro activity of tigecycline against multidrug-resistant Enterobacteriaceae isolates from a Belgian hospital

Eur J Clin Microbiol Infect Dis. 2009 Apr;28(4):381-4. doi: 10.1007/s10096-008-0629-9. Epub 2008 Sep 19.

Abstract

Bacterial resistance among Gram-negative pathogens is a challenging clinical problem. Tigecycline has been developed specifically to overcome resistance. The aim of this study was to assess the in vitro activity of tigecycline against ESBL-producing Escherichia coli, ESBL-producing Klebsiella spp., and multidrug-resistant Enterobacter spp. Between May 2007 and March 2008, 26 strains of ESBL-producing Escherichia coli, 10 strains of ESBL-producing Klebsiella spp., and 27 strains of multidrug-resistant Enterobacter spp. were isolated consecutively from inpatients with a documented infection in which the collected isolate was identified as the probable causative organism. The in vitro susceptibility against tigecycline was measured by the E-test method. MIC(50) values were 1 microg/ml, 2 microg/ml, and 3 microg/ml respectively. MIC(90) values were respectively 1.5 microg/ml, 4 microg/ml, and 12 microg/ml. Nonsusceptibility rates of 35%, 100%, and 96% respectively were found using EUCAST breakpoints. Despite the limited number of strains tested, our in vitro data suggest that tigecycline is unsuitable for the treatment of infections with multidrug-resistant Enterobacteriaceae in our setting. Therefore, we suggest that larger multicenter studies should be conducted to reconsider the value of tigecycline for the treatment of infections with multidrug-resistant, Gram-negative bacteria.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Belgium
  • Drug Resistance, Multiple, Bacterial*
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / isolation & purification
  • Enterobacteriaceae Infections / microbiology*
  • Hospitals
  • Humans
  • Microbial Sensitivity Tests
  • Minocycline / analogs & derivatives*
  • Minocycline / pharmacology
  • Tigecycline
  • beta-Lactam Resistance

Substances

  • Anti-Bacterial Agents
  • Tigecycline
  • Minocycline