In Vitro Activity of Tigecycline Against Acinetobacter baumannii: Global Epidemiology and Resistance Mechanisms

Pournaras, Spyros; Koumaki, Vasiliki; Gennimata, Vasiliki; Kouskouni, Evangelia; Tsakris, Athanassios

doi:10.1007/5584_2015_5001

Cited by 30 publications

(28 citation statements)

References 91 publications

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“…Unfortunately, although tigecycline was developed to overcome many of the efflux pump resistance mechanisms commonly seen with tetracyclines, rapid development of different resistance mechanisms have been observed. Current literature suggests that the development of such resistance has been associated with the TetX gene and, perhaps most importantly for A. baumannii , the overexpression of various efflux pumps (AdeABC, AdeIJK, AdeFGH, AbeM, AdeDE) [23, 24]. …”

Section: Mechanisms Of Action and Resistancementioning

confidence: 99%

Minocycline for the Treatment of Multidrug and Extensively Drug-Resistant A. baumannii: A Review

et al. 2017

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Acinetobacter baumannii can cause life-threatening nosocomial infections associated with high rates of morbidity and mortality. In recent years, the increasing number of infections due to extensively drug-resistant Acinetobacter with limited treatment options has resulted in a need for additional therapeutic agents, and a renaissance of older, neglected antimicrobials. This has led to an increased interest in the use of minocycline to treat these infections. Minocycline has been shown to overcome many resistance mechanisms affecting other tetracyclines in A. baumannii, including tigecycline. Additionally, it has favorable pharmacokinetic and pharmacodynamic properties, as well as excellent in vitro activity against drug-resistant A. baumannii. Available data support therapeutic success with minocycline, while ease of dosing with no need for renal or hepatic dose adjustments and improved safety have made it an appealing therapy. This review will focus on the mechanisms of action and resistance to tetracyclines in A. baumannii, the in vitro activity, pharmacokinetic and pharmacodynamic properties of minocycline against A. baumannii, and finally the clinical experience with minocycline for the treatment of invasive infections due to this pathogen.

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Section: Mechanisms Of Action and Resistancementioning

confidence: 99%

Minocycline for the Treatment of Multidrug and Extensively Drug-Resistant A. baumannii: A Review

et al. 2017

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“…Tigecycline resistance mechanisms are mainly associated with RND (resistance-nodulation-division division) transporters: the AdeABC, AdeFGH and AdeIJK efflux pumps, but other resistance mechanisms have also been implicated. [4,5] ESBL-producing enterobacteriaceae, since their first description in the 1980s, have caused numerous epidemics at the local, regional and international levels, frequently having as origin the resuscitation services. The commensal nature of these bacteria and the plasmid genetic support of the mechanism of resistance have allowed their spread on a very large scale.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Tigecycline Susceptibility in Multidrug-Resistant Bacteria at the University Hospital of Marrakech (Morocco)

Yassin¹,

Yassine²,

Khadija³

et al. 2019

AJLM

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The phenomenon of bacterial resistance to antibiotics is a major public health problem. The prevalence of multidrug-resistant bacteria is rapidly increasing with heavy consequences in terms of morbidity and mortality and health care costs. Tigecycline is a new active glycylcycline on this type of germ and could be a therapeutic alternative for the management of these infections. The aim of this work is to evaluate the in vitro activity of Tigecycline against multidrug-resistant organisms isolated at Mohammed VI hospital in Marrakech. It is a descriptive prospective study of a series of 171 multidrug-resistant bacteria including 102 clinical isolates of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL) and 85 clinical isolates of multidrug-resistant Acinetobacter baumannii. The in vitro activity of Tigecycline was measured by the determination of the minimum inhibitory concentration (MIC) by diffusion method on agar medium using the strips "E-test" according to the recommendations of the CASFM. 71% of Acinetobacter baumannii isolates were sensitive to Tigecycline of with MIC ≤1mg / l, while 17.6% of tested strains had intermediate sensitivity to Tigecycline with a MIC between 1 and 2 mg / l, 11,4% were resistant with a MIC> 2 mg / l. ESBL enterobacterial strains were mostly (77,5%) with a MIC ≤ 1 mg / l. Intermediate sensitivity was found in 15.6% of the isolates with a MIC between 1 and 2 mg / l, however, resistance to Tigecycline was found in 6.8% of enterobacterial isolates with a MIC> 2 mg /l. Tigecycline is an interesting therapeutic option and may have an important role in the treatment of multidrug-resistant infections. Detection of the sensitivity status of Tigecycline is necessary to optimize its use and preserve this molecule in our therapeutic arsenal.

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“…Interpretation of susceptibility testing results of tigecycline against A.baumannii has been controversial. Actually, the less specific breakpoints suggestion of FDA for Enterobacteriaceae (susceptible:2mg/L; resistant:8mg/L) or the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria for Enterobacteriaceae (susceptible:1mg/L; resistant:2mg/L) is widely used by researchers so far [15]. …”

Section: Resultsmentioning

confidence: 99%

Whole-Genome Analysis of an Extensive Drug-Resistant Acinetobacter Baumannii ST195 Isolate from a Recipient After DCD Renal Transplantation in China

Jiang

Cao

Shen

et al. 2017

Kidney Blood Press Res

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Background/Aims: Infection with Acinetobacter baumannii was emerging as one of the leading causes of mortality after donation after cardiac death transpalantion. Methods: We reported a case of a recipient who underwent DCD renal transplantation and later got infected by A.baumannii. Etests were done to verify the susceptibility test results in clinic. Whole-genome analysis was applied to investigate the resistant mechanism at gene level. Results: The pathogen was isolated from his draining liquid the day after the surgery, and susceptibility test reavealed that it was sensitive to tigecycline. However, the isolate obtained from the draining liquid became tigecycline-resistant after fifteen-day administration of tigecycline. The Susceptibility tests showed that the pathogen recovered from tigecycline resistance and became intermediated to tigecycline. Whole-Genome analysis revealed the genetic level change leading to tigecycline resistance and we identified the location of mutation by comparing the whole genome sequence of the isolates. Three loci were figured out which may contribute to drug resistance, including genes encoding HTH domain protein, MFS transporter and AdeS. Conclusion: Understanding the genetic characteristics associated with drug resistance mechanism and antimicrobial profiles of pathogen is important in controlling infection outbreak and preventing serious complications and gives a new insight into the development of antimicrobial agents.

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In Vitro Activity of Tigecycline Against Acinetobacter baumannii: Global Epidemiology and Resistance Mechanisms

Cited by 30 publications

References 91 publications

Minocycline for the Treatment of Multidrug and Extensively Drug-Resistant A. baumannii: A Review

Minocycline for the Treatment of Multidrug and Extensively Drug-Resistant A. baumannii: A Review

Evaluation of <i>Tigecycline</i> Susceptibility in Multidrug-Resistant Bacteria at the University Hospital of Marrakech (Morocco)

Whole-Genome Analysis of an Extensive Drug-Resistant <b><i>Acinetobacter Baumannii</i></b> ST195 Isolate from a Recipient After DCD Renal Transplantation in China

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In Vitro Activity of Tigecycline Against Acinetobacter baumannii: Global Epidemiology and Resistance Mechanisms

Cited by 30 publications

References 91 publications

Minocycline for the Treatment of Multidrug and Extensively Drug-Resistant A. baumannii: A Review

Minocycline for the Treatment of Multidrug and Extensively Drug-Resistant A. baumannii: A Review

Evaluation of &lt;i&gt;Tigecycline&lt;/i&gt; Susceptibility in Multidrug-Resistant Bacteria at the University Hospital of Marrakech (Morocco)

Whole-Genome Analysis of an Extensive Drug-Resistant <b><i>Acinetobacter Baumannii</i></b> ST195 Isolate from a Recipient After DCD Renal Transplantation in China

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Evaluation of <i>Tigecycline</i> Susceptibility in Multidrug-Resistant Bacteria at the University Hospital of Marrakech (Morocco)