Hospital Civil de Guadalajara, Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Clin Ther. 2012 Jan;34(1):101-12. doi: 10.1016/j.clinthera.2011.11.028. Epub 2011 Dec 16.
The Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) began in 2004 to monitor global antimicrobial susceptibility to tigecycline and a range of comparator antimicrobials among gram-positive and gram-negative organisms.
The aim of this study was to report changes in MIC for tigecycline and other antimicrobial agents among 10,149 Acinetobacter baumannii isolates collected globally between 2004 and 2009.
MICs of 10,149 isolates were determined locally using Clinical Laboratory and Standards Institute (CLSI) methodologies. Antimicrobial susceptibility was ascertained according to CLSI interpretive criteria (no interpretive criteria have been approved for tigecycline against Acinetobacter spp).
Increases in resistance were noted for most antimicrobial agents in all regions. Significant (P < 0.05) increases in percentage resistance were reported for all antimicrobial agents globally. The smallest changes in cumulative geometric mean MICs were reported for tigecycline (0.2 mg/L) and cefepime (3.5 mg/L). MIC(90)s were at the top of their testing ranges for most agents against both multidrug-resistant (MDR) and non-MDR isolates; only tigecycline showed little change in MIC(90) between MDR (2 mg/L) and non-MDR (1 mg/L) isolates. Resistance was higher among isolates from the intensive care unit (ICU) compared with non-ICU isolates.
These findings suggest that resistance is increasing among clinical isolates of A baumannii globally. Although resistance to tigecycline has been reported in the treatment of infections caused by A baumannii, it retains in vitro activity against this pathogen.
替加环素评估和监测试验(T.E.S.T.)于 2004 年开始,旨在监测全球革兰氏阳性和革兰氏阴性菌对替加环素和一系列比较抗菌药物的抗菌敏感性。
本研究旨在报告 2004 年至 2009 年间全球收集的 10149 株鲍曼不动杆菌分离株中替加环素和其他抗菌药物 MIC 的变化。
使用临床实验室和标准化协会(CLSI)方法在当地测定 10149 株分离株的 MIC。根据 CLSI 解释标准(尚未批准替加环素对不动杆菌属的解释标准)确定抗菌药物敏感性。
所有地区的大多数抗菌药物的耐药性均有所增加。全球所有抗菌药物的耐药率均显著(P < 0.05)增加。替加环素(0.2mg/L)和头孢吡肟(3.5mg/L)的累积几何均数 MIC 变化最小。大多数药物对多药耐药(MDR)和非 MDR 分离株的 MIC90 均处于其检测范围的上限;只有替加环素对 MDR(2mg/L)和非 MDR(1mg/L)分离株的 MIC90 变化不大。与非 ICU 分离株相比,ICU 分离株的耐药率更高。
这些发现表明,全球临床鲍曼不动杆菌分离株的耐药性正在增加。尽管替加环素在治疗由鲍曼不动杆菌引起的感染方面已被报道存在耐药性,但它对该病原体仍具有体外活性。