Annals of Tropical Medicine and Public Health
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Year : 2017  |  Volume : 10  |  Issue : 3  |  Page : 641-645

Evaluation of in vitro activity of tigecycline against carbapenemase-producing Gram-negative clinical isolates

Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India

Correspondence Address:
Rajkumar Manojkumar Singh
Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ATMPH.ATMPH_146_17

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Introduction: The emergence of carbapenem-resistant Gram-negative pathogens poses a serious overwhelming threat to public health worldwide. The paucity in developing novel antimicrobials escalates the antimicrobial resistance problem, severely reducing the available therapeutic options. Tigecycline, a broad-spectrum glycylcycline, is considered the last-resort antimicrobial agent for the treatment of multidrug-resistant Gram-negative bacteria, except for Pseudomonas aeruginosa and Proteus spp. Objectives: This study was conducted to assess the activity of tigecycline against carbapenem-resistant Gram-negative clinical isolates. Materials and Methods: A total of 247 consecutive, nonrepeat carbapenem-resistant Gram-negative clinical isolates, detected by the VITEK 2 Compact system with advanced expert system, were obtained during the period from January 2012 to December 2015. Minimal inhibitory concentrations to tigecycline were determined using agar dilution method, and the results were interpreted using Food and Drug Administration (FDA) and EUCAST breakpoints. Results: The minimum inhibitory concentration (MIC) of tigecycline required to inhibit the growth of 90% of organisms (MIC90) varied from 1 to 8 μg/ml for the study isolates, except for P. aeruginosa and Proteus mirabilis where MIC90is ≥16 μg/ml. Using FDA breakpoint, sensitivity rates of tigecycline varied from 68% to 92%, except P. aeruginosa and P. mirabilis. However, the susceptibility rate for the same isolates remained within 58% to 90%, following EUCAST breakpoint. Conclusions: Tigecycline exhibited potent in vitro activity against Gram-negative carbapenemase producers, except P. aeruginosa and Proteus spp. Its broad-spectrum activity combining with stability against common resistance mechanisms and the lack of cross-resistance with other classes of antimicrobials make tigecycline a therapeutic agent for the multidrug-resistant microorganisms.

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