JMI Laboratories, North Liberty, IA 52317, USA.
Diagn Microbiol Infect Dis. 2013 Jun;76(2):217-21. doi: 10.1016/j.diagmicrobio.2013.02.009. Epub 2013 Mar 19.
Tigecycline was approved by the United States Food and Drug Administration in 2005 and has generally retained activity against resistant Gram-positive and Gram-negative organisms. We monitored the in vitro activity of this glycylcycline in 2011 for continued potency worldwide. A total of 22,005 unique clinical isolates were consecutively collected in North America (NA; 9232 isolates), Europe (EU; 6776), Latin America (LA; 2016), and Asia-Pacific region (APAC, 3981) and tested for susceptibility according to the reference broth microdilution method recommendations against tigecycline and numerous comparators. Oxacillin (methicillin) resistance rates in methicillin-resistant Staphylococcus aureus (MRSA) were 49.3%, 30.2%, 42.9%, and 37.8%, and vancomycin resistance rates in enterococci (VRE) were 27.0%, 11.3%, 6.3%, and 4.0% in NA, EU, LA, and APAC, respectively. All MRSA (2839) and >99% of VRE were susceptible to tigecycline. Among Escherichia coli, extended-spectrum β-lactamase (ESBL) rates varied from 12.6% in the NA to 57.4% in APAC, and only one strain was nonsusceptible to tigecycline. Tigecycline was active against ESBL phenotype (96.5-98.4% susceptible) and meropenem-nonsusceptible Klebsiella spp. (94.3-100.0% susceptible). Only 4 of 213 (1.9%) meropenem-nonsusceptible Klebsiella spp. were tigecycline-nonsusceptible, all with tigecycline minimum inhibitory concentration (MIC) of 4 μg/mL (intermediate). Among ceftazidime-nonsusceptible Enterobacter spp., 94.7-98.2% were susceptible to tigecycline. Meropenem-nonsusceptible Acinetobacter spp. varied from 51.2% in NA to 80.9% in APAC; and 83.8% (LA) to 93.9% (APAC) of strains were inhibited at a tigecycline MIC of ≤2 μg/mL. Tigecycline showed potent activity against Stenotrophomonas maltophilia (89.3-98.3% inhibited at ≤2 μg/mL). In summary, tigecycline has sustained potent activity and a broad-spectrum against clinically important bacteria causing infections worldwide, including multidrug-resistant organism subsets.
替加环素于 2005 年获得美国食品和药物管理局批准，通常对耐药革兰阳性和革兰阴性菌保持活性。我们监测了这种甘氨酰环素在 2011 年全球的持续效力。共连续收集了来自北美（NA；9232 株）、欧洲（EU；6776 株）、拉丁美洲（LA；2016 株）和亚太地区（APAC，3981 株）的 22005 株独特的临床分离株，根据参考肉汤微量稀释法建议，对替加环素和许多对照药物进行药敏试验。耐甲氧西林金黄色葡萄球菌（MRSA）的苯唑西林（甲氧西林）耐药率分别为 49.3%、30.2%、42.9%和 37.8%，肠球菌（VRE）的万古霉素耐药率分别为 27.0%、11.3%、6.3%和 4.0%在 NA、EU、LA 和 APAC 中。所有 MRSA（2839 株）和 >99%的 VRE 均对替加环素敏感。在大肠杆菌中，扩展谱β-内酰胺酶（ESBL）的发生率从 NA 的 12.6%到 APAC 的 57.4%不等，只有一株对替加环素不敏感。替加环素对 ESBL 表型（96.5-98.4%敏感）和耐美罗培南的肺炎克雷伯菌属（94.3-100.0%敏感）具有活性。在 213 株耐美罗培南的肺炎克雷伯菌属中，仅有 4 株（1.9%）对替加环素不敏感，所有菌株的替加环素最小抑菌浓度（MIC）均为 4μg/ml（中介）。在头孢他啶不敏感的肠杆菌科中，94.7-98.2%对替加环素敏感。耐美罗培南的不动杆菌属在 NA 中的比例为 51.2%，在 APAC 中的比例为 80.9%；而在 LA（83.8%）和 APAC（93.9%）的菌株中，替加环素 MIC≤2μg/ml 可抑制 83.8%-93.9%的菌株。替加环素对嗜麦芽窄食单胞菌具有强大的活性（89.3-98.3%在≤2μg/ml 时被抑制）。总之，替加环素对引起全球感染的重要临床细菌具有持续的强效广谱活性，包括多种耐药菌亚群。
