Resistance trends and in vitro activity of tigecycline and 17 other antimicrobial agents against Gram-positive and Gram-negative organisms, including multidrug-resistant pathogens, in Germany

Kresken, Michael; Becker, Karsten; Seifert, Harald; Leitner, Eva; Körber-Irrgang, Barbara; Eiff, Christof von; Löschmann, Peter‐Andreas

doi:10.1007/s10096-011-1197-y

Cited by 29 publications

(20 citation statements)

References 30 publications

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“…No MRSA strains were resistant to tigecycline. These findings are consistent with data from the Tigecycline Evaluation Surveillance Trial and a recent German survey indicating invariably high antimicrobial activity of tigecycline against a broad spectrum of pathogens largely irrespective of their resistance to other antibiotic classes [44,45]. The number of resistant isolates documented in patients with therapeutic failure does not appear to support the notion of tigecycline resistance as a dominant contributor to therapeutic failure.…”

Section: Discussionsupporting

confidence: 79%

Therapy of 1,025 Severely Ill Patients with Complicated Infections in a German Multicenter Study: Safety Profile and Efficacy of Tigecycline in Different Treatment Modalities

Bodmann¹,

Heizmann²,

Eiff

et al. 2012

Chemotherapy

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This large prospective non-interventional study investigated the effects of tigecycline either as single agent or in combination with other antimicrobial agents in 1,025 patients treated in clinical routine at German hospitals. Sixty-five percent of the patients had APACHE II scores >15, indicating high overall disease severity. Complicated intra-abdominal infections (cIAI) or complicated skin and skin tissue infections (cSSTI) were the most common indications, with Staphylococcus aureus, Enterococcus faecium and Escherichia coli being the most frequently isolated pathogens. Clinical success was reported at the end of tigecycline therapy in 74.2% of the total population, in 75.4% of the cIAI and in 82.2% of the cSSTI patients. The subpopulation (28.0% of the patients) infected with multidrug-resistant pathogens (methicillin-resistant S. aureus, extended-spectrum β-lactamase producers and vancomycin-resistant enterococci) were treated with similar success rates as the overall population. Tigecycline was generally well tolerated. Drug-related adverse events (AEs) were reported in 7.7% of the total population; 2.5% had serious AEs mostly attributable to inefficacy of therapy or deterioration of the disease. Mortality rates were consistent with the types of infection and severity of illness. There was no indication of excessive mortality associated with tigecycline as had been suggested in previously performed meta-analyses. In this large non-interventional study performed in the clinical routine setting, tigecycline achieved favorable clinical success rates in a patient population with high severity of illness and a high prevalence of multidrug-resistant pathogens and showed a good safety and tolerability profile.

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Section: Discussionsupporting

confidence: 79%

Therapy of 1,025 Severely Ill Patients with Complicated Infections in a German Multicenter Study: Safety Profile and Efficacy of Tigecycline in Different Treatment Modalities

Bodmann¹,

Heizmann²,

Eiff

et al. 2012

Chemotherapy

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“…Tigecycline retains activity against many pathogens that are resistant to other widely used antimicrobial agents, including the carbapenems, and so may provide an important therapeutic alternative for the treatment of drug-resistant infections (32).…”

Section: Discussionmentioning

confidence: 99%

Global Assessment of Antimicrobial Susceptibility among Gram-Negative Organisms Collected from Pediatric Patients between 2004 and 2012: Results from the Tigecycline Evaluation and Surveillance Trial

Kehl

Dowzicky

2015

J Clin Microbiol

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bThe Tigecycline Evaluation and Surveillance Trial (TEST) was designed to monitor susceptibility to commonly used antimicrobial agents among important pathogens. We report here on susceptibility among Gram-negative pathogens collected globally from pediatric patients between 2004 and 2012. Antimicrobial susceptibility was determined using guidelines published by the Clinical and Laboratory Standards Institute (CLSI). Most Enterobacteriaceae showed high rates of susceptibility (>95%) to amikacin, tigecycline, and the carbapenems (imipenem and meropenem); 90.8% of Acinetobacter baumannii isolates were susceptible to minocycline, and susceptibility rates were highest in North America, Europe, and Asia/Pacific Rim. Amikacin was the most active agent against Pseudomonas aeruginosa (90.4% susceptibility), with susceptibility rates being highest in North America. Extended-spectrum ␤-lactamases (ESBLs) were reported for 11.0% of Escherichia coli isolates and 24.2% of Klebsiella pneumoniae isolates globally, with rates reaching as high as 25.7% in the Middle East and >43% in Africa and Latin America, respectively. Statistically significant (P < 0.01) differences in susceptibility rates were noted between pediatric age groups (1 to 5 years, 6 to 12 years, or 13 to 17 years of age), globally and in some regions, for all pathogens except Haemophilus influenzae. Significant (P < 0.01) differences were reported for all pathogens globally and in most regions, considerably more frequently, when pediatric and adult susceptibility results were compared. Amikacin, tigecycline, and the carbapenems were active in vitro against most Gram-negative pathogens collected from pediatric patients; A. baumannii and P. aeruginosa were susceptible to fewer antimicrobial agents. Susceptibility rates among isolates from pediatric patients were frequently different from those among isolates collected from adults. Bacterial infections in pediatric patients may behave differently than their corresponding infections in adults. Lob et al. showed that Escherichia coli isolates from adults with appendicitis were significantly (P Ͻ 0.05) less susceptible to a number of antimicrobial agents than were those from pediatric patients (1). Pediatric patients have rates of bacteremia up to 2-fold higher than those for adult patients and 7-fold higher than those for neonates (2). Unfortunately, results for pediatric and adult patients are often grouped together in population-based study reports (3).Key factors in the spread of serious Gram-negative bacilli include the development and spread of numerous resistance mechanisms, decreased research into the development of new antimicrobial agents, and widespread overuse of broad-spectrum antimicrobial agents in the treatment of infections, among other factors (4). Gram-negative pathogens are commonly associated with serious infections and high morbidity and mortality rates. Infections caused by Gram-negative pathogens are common causes of death among patients less than 14 years of age in the United Kingdom (5), and ...

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“…A recent study including 274 A. baumannii isolates recovered from 16 countries, including 14 countries from Europe, has reported an overall rate of imipenem-resistant strains of 48.9% [79]. Thus, resistance rates are higher in Turkey, Greece, Italy, Spain and England, with rates of 50-80%, 85%, 60%, 45% and 55%, respectively, compared with those in France, Germany and Sweden (10-20%, 8% and 4% resistance rates, respectively) [1,76,77,[80][81][82][83][84]. OXA-58-type was most frequently found in Europe during A. baumannii outbreaks, followed by OXA-23-type [55].…”

Section: Global Epidemiology Of Acinetobacter Baumannii In Europementioning

confidence: 90%

“…Nevertheless, information on the prevalence of carbapenem resistance in different European countries is difficult to obtain because A. baumannii is not a pathogen monitored by the European Antimicrobial Resistance Surveillance System (EARSS). In Germany, Kresken et al [76] have recently participated in the nationwide Tigecycline Evaluation and Surveillance Trial (TEST) and studied the susceptibility of 393 A. baumannii isolates against several antibiotics, including carbapenems. Results have shown a carbapenem resistance rate of 11.1% in 2007 and 8.2% in 2009.…”

Section: Global Epidemiology Of Acinetobacter Baumannii In Europementioning

confidence: 99%

Emergence of resistance to carbapenems in Acinetobacter baumannii in Europe: clinical impact and therapeutic options

Kempf

Rolain

2012

International Journal of Antimicrobial Agents

329

232

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Resistance trends and in vitro activity of tigecycline and 17 other antimicrobial agents against Gram-positive and Gram-negative organisms, including multidrug-resistant pathogens, in Germany

Cited by 29 publications

References 30 publications

Therapy of 1,025 Severely Ill Patients with Complicated Infections in a German Multicenter Study: Safety Profile and Efficacy of Tigecycline in Different Treatment Modalities

Therapy of 1,025 Severely Ill Patients with Complicated Infections in a German Multicenter Study: Safety Profile and Efficacy of Tigecycline in Different Treatment Modalities

Global Assessment of Antimicrobial Susceptibility among Gram-Negative Organisms Collected from Pediatric Patients between 2004 and 2012: Results from the Tigecycline Evaluation and Surveillance Trial

Emergence of resistance to carbapenems in Acinetobacter baumannii in Europe: clinical impact and therapeutic options

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