Trends in the Susceptibility of Clinically Important Resistant Bacteria to Tigecycline: Results from the TigecyclineIn VitroSurveillance in Taiwan Study, 2006 to 2010

Abstract

ABSTRACTThe TigecyclineIn VitroSurveillance in Taiwan (TIST) study, a nationwide, prospective surveillance during 2006 to 2010, collected a total of 7,793 clinical isolates, including methicillin-resistantStaphylococcus aureus(MRSA) (n= 1,834), penicillin-resistantStreptococcus pneumoniae(PRSP) (n= 423), vancomycin-resistant enterococci (VRE) (n= 219), extended-spectrum β-lactamase (ESBL)-producingEscherichia coli(n= 1,141), ESBL-producingKlebsiella pneumoniae(n= 1,330),Acinetobacter baumannii(n= 1,645), andStenotrophomonas maltophilia(n= 903), from different specimens from 20 different hospitals in Taiwan. MICs of tigecycline were determined following the criteria of the U.S. Food and Drug Administration (FDA) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST-2011). Among drug-resistant Gram-positive pathogens, all of the PRSP isolates were susceptible to tigecycline (MIC90, 0.03 μg/ml), and only one MRSA isolate (MIC90, 0.5 μg/ml) and three VRE isolates (MIC90, 0.125 μg/ml) were nonsusceptible to tigecycline. Among the Gram-negative bacteria, the tigecycline susceptibility rates were 99.65% for ESBL-producingE. coli(MIC90, 0.5 μg/ml) and 96.32% for ESBL-producingK. pneumoniae(MIC90, 2 μg/ml) when interpreted by FDA criteria but were 98.7% and 85.8%, respectively, when interpreted by EUCAST-2011 criteria. The susceptibility rate forA. baumannii(MIC90, 4 μg/ml) decreased from 80.9% in 2006 to 55.3% in 2009 but increased to 73.4% in 2010. A bimodal MIC distribution was found among carbapenem-susceptibleA. baumanniiisolates, and a unimodal MIC distribution was found among carbapenem-nonsusceptibleA. baumanniiisolates. In Taiwan, tigecycline continues to have excellentin vitroactivity against several major clinically important drug-resistant bacteria, with the exception ofA. baumannii.