Tigecycline susceptibility in Klebsiella pneumoniae and Escherichia coli causing neonatal septicaemia (2007–10) and role of an efflux pump in tigecycline non-susceptibility

“…Several studies have shown that tigecycline resistance in K. pneumoniae is associated with the overexpression of the acrAB operon (26) (27) . Additionally, a study by Wang et al found there was a statistically significant linear trend in the expression of acrB as the tigecycline MIC increased (14) .…”

Section: Discussionmentioning

confidence: 99%

Over expression of AdeABC and AcrAB-TolC efflux systems confers tigecycline resistance in clinical isolates of Acinetobacter baumannii and Klebsiella pneumoniae

Yin

Ziyun

Zhang

et al. 2016

Rev. Soc. Bras. Med. Trop.

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“…The present study showed that only 5 cases had prior use of tigecycline. One study from India also showed that tigecycline nonsusceptibility was not observed among CRKP isolates, and the increase of MIC values of tigecycline was not associated with the use of tigecycline (27). The geographic differences might be responsible for the different resistance phenotype of tigecycline-nonsusceptible K. pneumoniae between Asia and western countries.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors, Outcomes, and Mechanisms of Tigecycline-Nonsusceptible Klebsiella pneumoniae Bacteremia

Juan

Huang²,

Lin

et al. 2016

Antimicrob Agents Chemother

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A rise in tigecycline resistance in Klebsiella pneumoniae has been reported recently worldwide. We sought to identify risk factors, outcomes, and mechanisms for adult patients with tigecycline-nonsusceptible K. pneumoniae bacteremia in Taiwan. We conducted a matched case-control study (ratio of 1:1) in a medical center in Taiwan from January 2011 through June 2015. The cases were patients with tigecycline-nonsusceptible K. pneumoniae bacteremia, and the controls were patients with tigecyclinesusceptible K. pneumoniae bacteremia. Logistic regression was performed to evaluate the potential risk factors for tigecyclinenonsusceptible K. pneumoniae bacteremia. Quantitative reverse transcription-PCR was performed to analyze acrA, oqxA, ramA, rarA, and kpgA expression among these isolates. A total of 43 cases were matched with 43 controls. The 14-day mortality of patients with tigecycline-nonsusceptible K. pneumoniae bacteremia was 30.2%, and the 28-day mortality was 41.9%. The attributable mortalities of tigecycline-nonsusceptible K. pneumoniae at 14 and 28 days were 9.3 and 18.6%, respectively. Fluoroquinolone use within 30 days prior to bacteremia was the only independent risk factor for tigecycline-nonsusceptible K. pneumoniae bacteremia. The tigecycline-nonsusceptible K. pneumoniae bacteremia was mostly caused by overexpression of AcrAB and/or OqxAB efflux pumps, together with the upregulation of RamA and/or RarA, respectively. One isolate demonstrated isolated overexpression of kpgA. In conclusion, tigecycline-nonsusceptible K. pneumoniae bacteremia was associated with high mortality, and prior fluoroquinolone use was the independent risk factor for the acquisition of tigecycline-nonsusceptible K. pneumoniae. The overexpression of AcrAB and/or OqxAB contributes to tigecycline nonsusceptibility in K. pneumoniae.

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Tigecycline susceptibility in Klebsiella pneumoniae and Escherichia coli causing neonatal septicaemia (2007–10) and role of an efflux pump in tigecycline non-susceptibility

Cited by 55 publications

References 25 publications

Biofilm formation and antimicrobial resistance in Klebsiella pneumoniae isolated from patients visiting a tertiary care center of Nepal

Biofilm formation and antimicrobial resistance in Klebsiella pneumoniae isolated from patients visiting a tertiary care center of Nepal

Over expression of AdeABC and AcrAB-TolC efflux systems confers tigecycline resistance in clinical isolates of Acinetobacter baumannii and Klebsiella pneumoniae

Risk Factors, Outcomes, and Mechanisms of Tigecycline-Nonsusceptible Klebsiella pneumoniae Bacteremia

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