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Tigecycline Evaluation Surveillance Trial (TEST) – In vitro antibacterial activity against Gram-positive and Gram-negative pathogens in Europe

Abstract number: 1134_02_6

Bouchillon S., Stevens T., Johnson B., Johnson J., Hoban D., Hackel M., Person M., Dowzicky M.

Background:

Tigecycline, a member of a new class of antimicrobials (glycylcyclines), has been shown to have potent expanded broad spectrum activity against most commonly encountered species responsible for community and hospital acquired infections. The TEST program determined the in vitro activity of tigecycline compared to amikacin, ampicillin, imipenem, cefepime, ceftazidime, ceftriaxone, levofloxacin, minocycline, and piperacillin/tazobactam against gram negative rods in addition to linezolid, penicillin, and vancomycin for the gram positive species. Isolates were collected from hospitals located in Germany, Italy, Spain, and United Kingdom throughout 2004.

Methods:

A total of 1064 clinical isolates were identified to the species level at each participating site and confirmed by the central laboratory. Minimum Inhibitory Concentration (MICs) were determined by the local laboratory using supplied broth microdilution panels and interpreted according to NCCLS guidelines.

Results:

As shown in the table below, tigecycline's activity was similar to imipenem against Enterobacteriaceae. It inhibited multi-resistant ESBL and AmpC producers with MICs equal or lesser than 2 mcg/ml. Although similar to other classes of broad spectrum antimicrobial agents against glucose non-fermenters, tigecycline was especially active against Acinetobacter spp. presenting the lowest MIC90 of 1 mcg/ml. Tigecycline inhibited S. aureus with a MIC90 of 0.25 mcg/ml regardless of sensitivity or resistance to methicillin. The same results were noticed against enterococci where tigecycline's MIC90 of 0.25 mcg/ml was consistent regardless of vancomycin susceptibility.

Conclusion:

Tigecycline's in vitro activity was comparable to or greater than most commonly prescribed antimicrobials. The presented data suggest that tigecycline may be an effective and reliable therapeutic option against both aerobic gram-positive and aerobic gram-negative bacteria, including multi-drug resistant strains regardless of degree or type of resistance.

Table for P806

 Enterobacteriaceae (n=627)P.aeruginosa (n=101)Acinetobacter spp. (n=74)S. aureus (n=116)Enterococcus spp. (n=146)
RangeMIC50MIC90RangeMIC50MIC90RangeMIC50MIC90RangeMIC50MIC90RangeMIC50MIC90 
Tigecycline0.03–40.25010.5–>168>16<=0.008–40.2510.06–0.50.120.250.03–0.50.120.250
Amikacin0.5–3224<=0.5–1648<=0.5–>644>64      
Ampicillin1–>32>32>324–>32>32>32<=0.5–>32>32>320.06–>1616>160.25–>161>16
Cefepime0.5–>320.541–>32432<=0.5–>3216>32      
Ceftazidime8–>32832<=8–>32<=832<=8–>3232>32      
Ceftriazone0.06–>640.06164–>64>64>640.12–>64>64>640.5–>644>644–>64>64>64
Imipenem0.25–40.510.5–>161160.12–>160.5160.12–>160.25>160.25–>161>16
Levofloxacin0.008–>80.0680.03–>81>80.015–>84>80.06–160.2580.25–>328>32
Minocycline0.5–>16282–>16>16>16<=0.5–16180.25–80.250.50.25–>88>8
Pip/tazobactam0.12–>12818<=0.25–>1284128<=0.06–>12816>1280.25–>160.5>161–>164>16
Penicillin         0.06–>8>8>81–>84>8
Linezolid         1–4241–>422
Vancomycin         0.5–2110.5–212

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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