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Antimicrobial activity of tigecycline and comparator agents tested against clinical bacterial strains from the Asia-Pacific region, 20082009

Abstract number: P1646

Bell J.M., Sader H., Farrell D., Jones R., Turnidge J.

Background: To assess the activity of tigecycline and comparator agents against strains collected in various countries in the Asia-Pacific (APAC) region. Tigecycline is the first glycylcycline approved for clinical use and has demonstrated activity against key Gram-positive and -negative bacterial pathogens worldwide, including multidrug-resistant (MDR) Acinetobacter spp., ESBL-producing Enterobacteriaceae (ENT), methicillin-resistant S. aureus (MRSA), and vancomycin-resistant enterococci (VRE); pathogens frequently isolated in the APAC region.

Methods: As part of the SENTRY Antimicrobial Surveillance Program, 35 institutions from 8 nations contributed 9,804 strains as follows (no. of medical centres/strains): Australia (7/2,494), China (CH; 17/4,098), Hong Kong China (1/395), South Korea (KOR; 3/960), New Zealand (NZ; 3/634), Singapore (SIN; 1/433), Taiwan (TW; 2/590) and Thailand (1/200). All isolates were forwarded to a central laboratory (USA or Australia) where they were tested against tigecycline and comparators by CLSI broth microdilution methods. CLSI and EUCAST interpretations were applied for comparison agents. Tigecycline breakpoints published by the USA-FDA were applied for indicated species.

Results: MRSA rate was 43.4% overall, ranging from 8.7% in NZ to 70.1% in SIN and 77.3% in KOR. 83.6% of coagulase-negative staphylococci were resistant to oxacillin. VRE rates (10.1% overall) were highest in TW (47.4%) and KOR (32.6%). Prevalences of ESBL phenotype among E. coli/Klebsiella spp. were 35.4/33.7% overall, highest in TW (41.9/54.2%) and CH (62.0/42.6%). Imipenem (IMI) resistance (R) among Acinetobacter spp. was 49.5% overall, highest in KOR (78.7%) and SIN (87.5%). Tigecycline was very active against the most frequently isolated organisms, except P. aeruginosa (Table). >99% of staphylococci and enterococci were inhibited at leqslant R: less-than-or-eq, slant0.5 mg/L of tigecycline. Among ENT (including ESBL-producing strains) and Acinetobacter spp. (including IMI-R strains) 97.8–100.0% were inhibited at leqslant R: less-than-or-eq, slant2 mg/L of tigecycline.

Conclusion: Almost 10,000 clinical strains from the APAC region were tested and tigecycline was very active against the organisms most frequently recovered from the hospitals evaluated, except P. aeruginosa. Tigecycline spectrum included MRSA, VRE, ENT with ESBL phenotype and IMI-R Acinetobacter spp. Tigecycline appears to be a valuable option for the treatment of infections caused by MDR organisms frequently isolated in the APAC region.

Table 1

Organism (no. tested)Cumulative % inhibited at tigecycline MIC (mg/L) of:
 leqslant R: less-than-or-eq, slant0.060.120.250.5124
S. aureus (3,142)2.029.792.199.5100.0
CoNS (214)4.731.386.999.1100.0
Enterococcus spp. (1,129)11.651.197.999.8100.0
b-haemolytic strep. (362)93.498.6100.0
Viridans group strep. (96)90.696.999.0100.0
S. pneumoniae (907)84.293.7100.0
E. coli (1,056)1.629.791.199.199.8100.0
Klebsiella spp. (714)0.01.732.180.595.998.399.9
Enterobacter spp. (405)0.00.521.785.294.397.899.0
Acinetobacter spp. (533)4.719.732.549.289.799.1100.0
P. aeruginosa (731)0.00.00.30.61.14.222.2

Session Details

Date: 10/04/2010
Time: 00:00-00:00
Session name: Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Vienna, Austria, 10 - 13 April 2010
Presentation type:
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