Fernández Canigia Liliana, Kaufman Sara, Lanata Liliana, Vay Carlos, Giovanakis Marta, Bantar Carlos
Reference Laboratory, Hospital Alemán, Pueyrredón 1640, Buenos Aires, Argentina.
Chemotherapy. 2009;55(1):20-7. doi: 10.1159/000167788. Epub 2008 Oct 31.
Tigecycline is a new antibiotic currently used in healthcare environments where multidrug resistance is prominent. Because there is a constant potential for resistance to emerge, survey studies are needed.
Isolates collected in 20 clinical laboratories from 4 states of Argentina between November 2005 and October 2006 were tested using the disk diffusion method as described by the CLSI.
A total of 3,182 isolates were assessed. Gram-positive cocci represented 43.4% of the total isolates [Staphylococcus aureus (878), coagulase-negative staphylococci (255), Enterococcus spp. (201), Streptococcus spp. (47)], Enterobacteriaceae 39.6% and Acinetobacter spp. 11.1%. Tigecycline proved equally active against methicillin-resistant and methicillin-susceptible staphylococci, as well as against vancomycin-resistant and vancomycin-susceptible enterococci (100% of susceptibility for all Gram-positive bacteria tested). Tigecycline susceptibility for Enterobacteriaceae, other than Proteeae tribe and Serratia spp., ranged from 88 to 100%, including against strains with resistance to third-generation cephalosporins with phenotype of extended spectrum beta-lactamases (extended spectrum beta-lactamase-positive Escherichia coli 17.7% and extended spectrum beta-lactamase-positive Klebsiella pneumoniae 50.5%). Adopting a resistant breakpoint of 16 mm, 92% of the Acinetobacter isolates were susceptible to tigecycline.
CONCLUSION(S): Tigecycline was active against a wide variety of bacterial species, including most of the multidrug-resistant Gram-negative and Gram-positive bacteria. Therefore, it could be a suitable option in the treatment of infections caused by these organisms in hospitalized patients.
替加环素是一种新型抗生素，目前用于多重耐药性突出的医疗环境中。由于不断有产生耐药性的可能性，因此需要进行调查研究。
采用美国临床和实验室标准协会（CLSI）描述的纸片扩散法，对2005年11月至2006年10月期间从阿根廷4个州的20个临床实验室收集的分离株进行检测。
共评估了3182株分离株。革兰氏阳性球菌占分离株总数的43.4%[金黄色葡萄球菌（878株）、凝固酶阴性葡萄球菌（255株）、肠球菌属（201株）、链球菌属（47株）]，肠杆菌科占39.6%，不动杆菌属占11.1%。替加环素对耐甲氧西林和甲氧西林敏感的葡萄球菌以及耐万古霉素和万古霉素敏感的肠球菌同样具有活性（所有检测的革兰氏阳性菌的敏感性均为100%）。除变形杆菌族和沙雷菌属外，替加环素对肠杆菌科的敏感性范围为88%至100%，包括对具有超广谱β-内酰胺酶表型的第三代头孢菌素耐药的菌株（超广谱β-内酰胺酶阳性大肠埃希菌为17.7%，超广谱β-内酰胺酶阳性肺炎克雷伯菌为50.5%）。采用16毫米的耐药断点，92%的不动杆菌分离株对替加环素敏感。
替加环素对多种细菌具有活性，包括大多数多重耐药的革兰氏阴性菌和革兰氏阳性菌。因此，它可能是治疗住院患者中由这些微生物引起的感染的合适选择。
