Centre Hospitalier Universitaire Besançon, Besançon, France.
Clin Ther. 2012 Jan;34(1):124-37. doi: 10.1016/j.clinthera.2011.11.023. Epub 2011 Dec 9.
The Tigecycline Evaluation and Surveillance Trial is an antimicrobial susceptibility surveillance program that collects gram-positive and gram-negative organisms globally.
This analysis reports on antimicrobial susceptibility among 23,918 gram-negative isolates collected from intensive care units globally between 2004 and 2009.
MICs and susceptibility were determined according to the guidelines of the Clinical and Laboratory Standards Institute (US Food and Drug Administration breakpoints were applied against tigecycline).
Gram-negative isolates were collected from 6 geographical regions: North America, 8099 isolates; Europe, 9244; Asia-Pacific Rim, 1573; Latin America, 3996; the Middle East, 635; and Africa, 371. North America reported the lowest rates of extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae and Escherichia coli both overall (12.8% and 4.7%, respectively) and in each year of collection. High rates of ESBL production were reported among K pneumoniae from Latin America (45.5%) and Africa (54.9%) and for E coli from the Middle East (32.4%). Imipenem and tigecycline maintained >90% susceptibility against K pneumoniae, E coli, Klebsiella oxytoca, Enterobacter cloacae, and Serratia marcescens for all regions. Susceptibility to meropenem was >90% against all K oxytoca and S marcescens. Large regional variations in susceptibility among Acinetobacter baumannii were reported, with the largest variations reported for amikacin (75.2% in North America, 21.8% in the Middle East) and meropenem (60.4% in North America, 15.9% in Africa). MIC(90) values for tigecycline against A baumannii were low (1-2 mg/L) for all regions. Against P aeruginosa, susceptibility to amikacin (97.5% in North America, 67.5% in Latin America) and meropenem (79.1% in North America, 51.4% in Africa) had the largest variations.
Antimicrobial resistance among gram-negative intensive care unit isolates was highly variable between geographic regions. The carbapenems were active in vitro against Enterobacteriaceae, A baumannii and P aeruginosa, and tigecycline continued to be active in vitro against members of the Enterobacteriaceae and A baumannii collected from intensive care units in North America, Europe, the Asia-Pacific Rim, Latin America, the Middle East, and Africa.
替加环素评估和监测试验是一项抗菌药物敏感性监测项目，在全球范围内收集革兰氏阳性和革兰氏阴性菌。
本分析报告了 2004 年至 2009 年间全球重症监护病房采集的 23918 株革兰氏阴性菌的抗菌药物敏感性。
根据临床和实验室标准协会（美国食品和药物管理局的标准进行 MIC 和药敏试验（针对替加环素应用了美国食品和药物管理局的折点）。
从北美、欧洲、亚太地区、拉丁美洲、中东和非洲 6 个地理区域收集了革兰氏阴性菌分离株：北美，8099 株；欧洲，9244 株；亚太地区，1573 株；拉丁美洲，3996 株；中东，635 株；非洲，371 株。北美报告的产超广谱β-内酰胺酶（ESBL）肺炎克雷伯菌和大肠埃希菌的总体（分别为 12.8%和 4.7%）和每年的产酶率最低。拉丁美洲（45.5%）和非洲（54.9%）产 ESBL 的肺炎克雷伯菌和中东（32.4%）产 ESBL 的大肠埃希菌的产酶率很高。所有地区的替加环素对肺炎克雷伯菌、大肠埃希菌、产酸克雷伯菌、阴沟肠杆菌和粘质沙雷氏菌的敏感性均保持>90%。美罗培南对所有产酸克雷伯菌和粘质沙雷氏菌的敏感性>90%。鲍曼不动杆菌的区域间药敏差异很大，其中阿米卡星（北美 75.2%，中东 21.8%）和美罗培南（北美 60.4%，非洲 15.9%）的差异最大。替加环素对鲍曼不动杆菌的 MIC90 值较低（所有地区均为 1-2mg/L）。对铜绿假单胞菌，阿米卡星（北美 97.5%，拉丁美洲 67.5%）和美罗培南（北美 79.1%，非洲 51.4%）的敏感性差异最大。
重症监护病房革兰氏阴性菌分离株的抗菌药物耐药性在地理区域之间高度不同。碳青霉烯类药物对肠杆菌科、鲍曼不动杆菌和铜绿假单胞菌具有体外活性，替加环素对北美、欧洲、亚太地区、拉丁美洲、中东和非洲重症监护病房采集的肠杆菌科和鲍曼不动杆菌成员也保持体外活性。
