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In vitro activity of tigecycline and other broad spectrum antibiotics against micro-organisms isolated from infected patients in Colombia

Abstract number: R2123

Leal A.L., Buitrago G., Cortes J.A., Ovalle M.V., Alvarez C.A., Castillo J.S., La Rotta J., Galo S.

Objective: There are usually changes in the susceptibility profiles of antibiotics after their introduction in clinical use. Surveillance studies are important because they show the magnitude and trend of the change. A surveillance of tigecycline, two years after its introduction in Colombia is presented.

Methods: A surveillance study from 13 institutions in 8 different cities in Colombia was made. Microorganisms isolated from hospitalised patients with a microbiologically proven diagnosis of infection were sent to a reference centre. Antimicrobial activity was tested by a microdilution method for tigecycline (Trek diagnostics, London) and other broad spectrum antibiotics (MicroScan, Dade Behring, CA) commonly used. For interpretation CLSI rules were used and, for tigecycline, FDA approved breakpoints were used. No Pseudomonas species were collected.

Results: 802 isolates were collected (S. aureus 28%, E. coli 26%, Klebsiella spp. 18%, A. baumannii 10%, Enterococcus spp.7%, Enterobacter spp. 6% and S. marcescens 5%). Isolates were recovered from bloodstream (33%), skin and soft tissue (17%), surgical site infection (17%), abdomen (15%), respiratory tract (14%) and bone (4%). Susceptibility is shown according to the infection site and microorganism in Table 1.

Conclusion: Susceptibility profile of tigecycline is still very high after 2 years of clinical use. A high resistance profile is observed among collected isolates and limited therapeutic options are available.

Table 1. Susceptibility according to the infection site and microorganism

 n% S % STGC
  OXAVANAMKFEPCIPCAZCROIMIMEMTZP% ESBLSAMCSLaCOLaMINa%SMIC50MIC90
Blood265                  
Acinetobacter baumanniib22  363131  313127 50090861000.51
Enterobacter spp.15  868086666610010073 13   1000.51
Escherichia coli72  98796879791001008716.741   1000.250.5
Klebsiella spp.56  877176717192c87c7132.155   1000.51
Serratia marcescens13  53761001006110010092 0   10011
Staphylococcus aureus7365100  79          1000.1250.25
Enterococcus spp.14 93             1000.1250.25
Skin and soft tissue137                  
Acinetobacter baumanniib9  111111  222211 3301001001000.251
Enterobacter spp.11  728154726310010081 9   1000.51
Escherichia coli22  86635463631001008631.831   1000.251
Klebsiella spp.15  938073808093c93c602046   1000.51
Serratia marcescens11  729090818110010081 9   1000.51
Staphylococcus aureus6162100  90          1000.1250.25
Enterococcus spp.8 100             1000.1250.25
Abdominal120                  
Acinetobacter baumanniib10  4000  10100 10090801000.51
Enterobacter spp.8  756275505010010050 25   1000.51
Escherichia coli58  98867086861001007910.329   1000.250.5
Klebsiella spp.21  85667671711001004228.642   1000.51
Serratia marcescens2  100100100100100100100100 0   1000.1250.5
Staphylococcus aureus825100  37          1000.1250.25
Enterococcus spp.13 100             1000.1250.25
Respiratory tract111                  
Acinetobacter baumanniib21  3344  999 90761001000.51
Enterobacter spp.5  1006080606010010080 40   1000.51
Escherichia coli9  100776677881001007722.211   1000.251
Klebsiella spp.36  977586697597c97c612538   1000.51
Serratia marcescens8  10010087100100100100100 12   1000.52
Staphylococcus aureus3259100  68          1000.1250.25
Enterococcus spp.0                  
Surgical site infection136                  
Acinetobacter baumanniib12  666658  756666 75091831000.250.5
Enterobacter spp.11  543654273610010036 18   1000.51
Escherichia coli43  8179697979100100741427   1000.250.5
Klebsiella spp.12  755850585810091c4141.733   1000.51
Serratia marcescens4  75100257575100100100 0   1000.51
Staphylococcus aureus4143100  70          1000.1250.25
Enterococcus spp.13 100             1000.1250.25
Bone32                  
Acinetobacter baumanniib6  16160  333316 16083831000.251
Enterobacter spp.2  505050505010010050 50   1000.251
Escherichia coli4  10010075100100100100100050   1000.251
Klebsiella spp.3  100336633331001003366.733   10011
Serratia marcescens1  100100100100100100100100 0   10011
Staphylococcus aureus1353100  84          1000.1250.25
Enterococcus spp.3 100             1000.0640.125
aE-test susceptibility. bEnterobacteriaceae breakpoints for tigecycline. cMolecular confirmation.
OXA, oxacillin; VAN, vancomycin; AMK, amikacin; FEP, cefepime; CIP, ciprofloxacin; CAZ, ceftazidime; CRO, ceftriaxone; ESBL, extended-spectrum beta-lactamase; IMI, imipenem; MEM, meropenem; TZP, piperacillin/tazobactam; SAM, ampicillin/sulbactam; CSL, cefoperazone/sulbactam; COL, colistin; MIN, minocycline; TGC, tigecycline; %S, percent susceptibility.

Session Details

Date: 16/05/2009
Time: 00:00-00:00
Session name: 19th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Helsinki, Finland, 16 - 19 May 2009
Presentation type:
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