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Objectives: Tigecycline (TIG) has potent expanded broad spectrum activity against most commonly encountered species responsible for community and hospital acquired infections. The T.E.S.T. program determined the in vitro activity of TIG against Acinetobacter resistant to one or more of piperacillin-tazobactam (PT), levofloxacin (LVX), ceftriaxone (CAX), cefepime (CPE), amikacin (AK), minocycline (MIN), ceftazidime (CAZ), meropenem (MER) and imipenem (IMP). Study strains were collected from hospitals in the United States from 2004-2008. Methods: A total of 3,507 clinical Acinetobacter were identified to species level from participating sites and confirmed by the central laboratory. 1025/3507 (29.2%) of these isolates were determined to be multidrug resistant (resistant to 3 or more drug classes). Minimum Inhibitory Concentrations (MICs) were determined by the local laboratory using supplied broth microdilution panels and interpreted according to CLSI guidelines. Results: Resistance rates for comparator drugs were CAZ 95%, CAX 94%, LVX 94%, CPE 82%, PT 80%, AK 33%, MIN 11%, MER 72% and IMP 37%. TIG inhibited 95% of all isolates at 8 mcg/ml. TIG MIC 50/90 for strains resistant to 0, 1, 2, 3, 4, or >5 drug classes were 0.12/0.5, 0.5/1, 1/2, 1/2, 1/2, and 1/2, respectively, demonstrating a gradual diminishment of TIG activity in strains resistant to multiple drug classes. Conclusions: TIG had good in vitro activity against most Acinetobacter strains resistant to one or more other drugs in this study, although the higher TIG MICs seen for these strains suggests some linkage to resistance mechanisms for other drugs (efflux). TIG remained effective in inhibiting multidrug resistant Acinetobacter spp., further demonstrating its wide spectrum of activity vs. drug-resistant bacteria. IHMA, Inc. 2122 Palmer Dr. Schaumburg, IL 60173 Tel: (847) 303-5003 Fax: (847) 303-5601 www.ihmainc.com |
