Antimicrobial susceptibility among gram-positive and gram-negative blood-borne pathogens collected between 2012-2016 as part of the Tigecycline Evaluation and Surveillance Trial

Abstract

BackgroundAntimicrobial activity of tigecycline and comparator agents was assessedin vitroagainst 27857 isolates source from blood samples collected between 2012 and 2016 as part of the Tigecycline Evaluation and Surveillance Trial (TEST).MethodsThe broth microdilution methods was used to determine minimum inhibitory concentrations (MIC) of blood-borne isolates according to guildlines of the Clinical and Laboratory Standards Institute (CLSI). Antimicrobial susceptibility breakpoints from CLSI guidelines were used as standards to determine susceptibility against comparator agents, whereas tigecycline breakpoints were provided by the US Food and Drug Administration (FDA).ResultsMore than 91% Enterobacteriaceae isolates, belonging to Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacaeandSerratia marcescens, were susceptible to amikacin, meropenem, and tigecycline. Meropenem resistance was observed in 8% ofK.pneumoniae isolates worldwide. Extended-spectrum β-lactamase (ESBL) was produced in 15.9 and 20.9%E.coli and K.pneumoniaeisolates, respectively. MIC90 of tigecycline against Acinetobacter baumannii was 2 μg/ml. The highest proportion of susceptible A.baumanniiisolates was 70.8% for minocycline. Among P.aeruginose isolates worldwide, 71.1–94.9% were susceptible to six antibiotics. Almost all Staphylococcus aureusisolates were susceptible to linezolid(100%), vancomycin(100%), and tigecycline (99.9%). The proportion of methicillin-resistant S.aureus (MRSA) was 33.0% among S.aureusisolates worldwide; it was highest in Asia with 46.6%, followed by North America and Latin America with 37.7 and 34.2%, respectively. Vancomycin-resistant (VR) isolates represented 1.4% ofEnterococcus faecalis (VR.E.faecalis) and 27.6% of Enterococcus faecium(VR.E.faecium). Highest percentages of VR.E.faeciumwere found in North America and Latin America, with 61.6 and 58.1% of the isolates, respectively. Production of penicillin-resistant Streptococcus pneumoniae(PRSP) represented 9.0% of S. pneumoniae isolates worldwide; the PRSP proportion was 25.8% in Asia, 13.0% in Africa, and 11.8% in Latin America.ConclusionsIn our study, tigecycline was the only antibiotic that was active against over 90% of all major blood-borne pathogens. A global comparison revealed that antimicrobial resistance was higher in Africa, Asia and Latin America than in Europe and North America.

High contribution and impact of resistant gram negative pathogens causing surgical site infections at a multi-hospital healthcare system in Saudi Arabia, 2007–2016

“…For VRE, the current rates (13%) was comparable to recent reports from Saudi Arabia [28]. Additionally, it was comparable to international rates [5,24], with exception of North and South American ones which traditionally have very high rates of VRE [8,9,24]. Despite the relatively low resistance of GPPs observed in the current and local studies, reports has warned from an increasing trend in the resistance of GPPs in Saudi Arabia, specially VRE, probably due to overuse of broad-spectrum antimicrobials and development of new resistance patterns [27,28].…”

“…In addition to the low contribution, GPPs causing SSI in the current study were generally less resistant than reported internationally. For example, MRSA rates was 30% in the current study compared with more than 40% in USA [8,9], Europe [5], and Asia [24,25]. In Saudi Arabia, there has been a great variability in the published MRSA rates, probably due to mixing community and hospital isolates as well as clinical and surveillance isolates [26,27].…”

High Contribution and Impact of Resistant Gram Negative Pathogens Causing Surgical Site infections at a Multi-Hospital Healthcare System in Saudi Arabia, 2007-2016

“…For VRE, the current rates (13%) was comparable to recent reports from Saudi Arabia [35]. Additionally, it was comparable to international rates [5,31], with exception of North and South American ones which traditionally have very high rates of VRE [14,15,31]. Despite the relatively low resistance of GPPs observed in the current and local studies, reports has warned from an increasing trend in the resistance of GPPs in Saudi Arabia, specially VRE, probably due to overuse of broad-spectrum antimicrobials and development of new resistance patterns [34,35].…”

“…In addition to the low contribution, GPPs causing SSI in the current study was generally less resistant than reported internationally. For example, MRSA rates was 30% in the current study compared with more than 40% in USA [14,15], Europe [5], and Asia [31,32]. In Saudi Arabia, there has been a great variability in the published MRSA rates, probably due to mixing community and hospital isolates as well as clinical and surveillance isolates [33,34].…”

Global trends of antimicrobial susceptibility of ceftaroline and ceftazidime-avibactam: a surveillance study from the ATLAS program (2012-2016)

“…34 The TEST study showed that Africa and Asia were the two regions of the world with the highest occurrence of S. aureus resistant to multiple antibiotics among blood-borne infections. 35 There is a plea for worldwide, automated, and comprehensive surveillance of antimicrobial resistance patterns. 8,36,37 Such surveillance could help optimize the worldwide use of antibiotics to improve infection control and minimize the occurrenceof resistant strains.…”