Comparative in vitro activity of tigecycline against enterobacteria producing two or more extended-spectrum β-lactamases

Vázquez, María Dolores Cid; Romero, E; García, María Inmaculada García; Rodríguez, José Ángel García; Muñoz‐Bellido, Juan Luis

doi:10.1016/j.ijantimicag.2008.06.024

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…By using the Etest method we found that 97.9% of the typed E. coli (n = 195) and 78.8% of the typed K. pneumoniae (n = 33) ESBL-producing isolates were susceptible to tigecycline, whereas a previous surveillance study performed in 2005 in Germany reported 100% of the tested ESBL-producing E. coli isolates to be susceptible to tigecycline [32]. The percentage of 21.2% non-susceptible K. pneumoniae isolates seems to be low, as others have reported up to 44.4% of ESBL-producing K. pneumoniae isolates not susceptible to tigecycline within the European Committee for Antimicrobial Susceptibility Testing criteria [17]. A mechanism described for reduced susceptibility of K. pneumoniae to tigecycline is an elevated expression of AcrAB efflux pumps [33].…”

Section: Discussionmentioning

confidence: 99%

“…The increasingly reported non-susceptibility of ESBL-producing Enterobacteriaceae to carbapenems can be attributed to the expression of carbapenemases or loss of porins combined with expression of AmpC β-lactamases or ESBLs [15,16]. Recently, even non-susceptibility of ESBL producers to the glycylcycline tigecycline has been described [13,17]. …”

Section: Introductionmentioning

confidence: 99%

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In vitro Activity of Tigecycline and Molecular Characterization of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Isolates from a University Hospital in South-Western Germany

et al. 2012

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Background: Extended-spectrum β-lactamase (ESBL)-producing organisms are spreading worldwide in hospital and community settings. Methods: A total of 328 unduplicated ESBL-producing Enterobacteriaceae isolated in 2008 and 2009 at the University Hospital of Tübingen were analysed retrospectively. Results:Escherichia coli (n = 253) and Klebsiella spp. (n = 46) were the most frequent ESBL-producing species. The ESBL rates among E. coli and Klebsiella spp. increased from 3.8 and 2.1%, respectively, in 2008, to 5.2 and 2.4%, respectively, in 2009. Two E. coli and 3 Klebsiella pneumoniae ESBL producers were non-susceptible to ertapenem, most likely due to loss of porins. Antimicrobial susceptibility testing of selected, molecularly characterized ESBL producers revealed susceptibility to tigecycline among 97.9% (191/195) of the E. coli and 78.8% (26/33) of the K. pneumoniae isolates. PCR analysis and sequencing showed the presence of CTX-M-type enzymes in 91.3% of the E. coli and 87.9% of the K. pneumoniae isolates, whereby bla_CTX-M-15 was the most frequent ESBL gene both in E. coli (50.0%) and K. pneumoniae (51.5%). Only 7 single cases of potential patient-to-patient transmissions of E. coli strains were observed. Conclusions: Our data suggest that the increase in ESBL-producing E. coli and K. pneumoniae isolates at our hospital is mainly caused by growing import of Enterobacteriaceae harbouring CTX-M-type ESBLs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

In vitro Activity of Tigecycline and Molecular Characterization of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Isolates from a University Hospital in South-Western Germany

et al. 2012

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“…The resistance rate to tigecycline in multidrug-resistant K . pneumoniae in the USA was approximately 9.2% (MIC≥8 mg/L, FDA) [ 6 ], while the resistance rate in ESBL-producing isolates was approximately 33.3% in Spain (MIC >2 mg/L, EUCAST) [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Tigecycline Susceptibility and the Role of Efflux Pumps in Tigecycline Resistance in KPC-Producing Klebsiella pneumoniae

Chen

et al. 2015

PLoS ONE

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KPC-producing Klebsiella pneumoniae isolates have emerged as important pathogens of nosocomial infections, and tigecycline is one of the antibiotics recommended for severe infections caused by KPC-producing K. pneumoniae. To identify the susceptibility profile of KPC-producing K. pneumoniae to tigecycline and investigate the role of efflux pumps in tigecycline resistance, a total of 215 KPC-producing K. pneumoniae isolates were collected. The minimum inhibitory concentration (MIC) of tigecycline was determined by standard broth microdilution tests. Isolates showing resistance to tigecycline underwent susceptibility test with efflux pump inhibitors. Expression levels of efflux pump genes (acrB and oqxB) and their regulators (ramA, marA, soxS and rarA) were examined by real-time PCR, and the correlation between tigecycline MICs and gene expression levels were analysed. Our results show that the tigecycline resistance rate in these isolates was 11.2%. Exposure of the tigecycline-resistant isolates to the efflux pump inhibitor NMP resulted in an obvious decrease in MICs and restored susceptibility to tigecycline in 91.7% of the isolates. A statistically significant association between acrB expression and tigecycline MICs was observed, and overexpression of ramA was found in three tigecycline-resistant isolates, further analysis confirmed ramR mutations existed in these isolates. Transformation of one mutant with wild-type ramR restored susceptibility to tigecycline and repressed overexpression of ramA and acrB. These data indicate that efflux pump AcrAB, which can be up-regulated by ramR mutations and subsequent ramA activation, contributed to tigecycline resistance in K. pneumoniae clinical isolates.

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The emergence of clinical resistance to tigecycline

Sun

Cai

Liu

et al. 2013

International Journal of Antimicrobial Agents

163

122

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Comparative in vitro activity of tigecycline against enterobacteria producing two or more extended-spectrum β-lactamases

Cited by 4 publications

References 6 publications

In vitro Activity of Tigecycline and Molecular Characterization of Extended-Spectrum Beta-Lactamase-Producing <b><i>Escherichia coli</i></b> and <b><i>Klebsiella pneumoniae</i></b> Isolates from a University Hospital in South-Western Germany

In vitro Activity of Tigecycline and Molecular Characterization of Extended-Spectrum Beta-Lactamase-Producing <b><i>Escherichia coli</i></b> and <b><i>Klebsiella pneumoniae</i></b> Isolates from a University Hospital in South-Western Germany

Tigecycline Susceptibility and the Role of Efflux Pumps in Tigecycline Resistance in KPC-Producing Klebsiella pneumoniae

The emergence of clinical resistance to tigecycline

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