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Open Access Research

Antimicrobial susceptibility among gram-negative isolates collected in the USA between 2005 and 2011 as part of the Tigecycline Evaluation and Surveillance Trial (T.E.S.T.)

Gerald A Denys1*, Steven M Callister2 and Michael J Dowzicky3

Author Affiliations

1 Indiana University Health Pathology Laboratory, Indianapolis 46202, IN, USA

2 Microbiology Research and Molecular Diagnostics Laboratory, Gundersen Health System, La Crosse, Wisconsin 54601, USA

3 Pfizer Inc, 500 Arcola Road, E-Dock, Collegeville 19426, PA, USA

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Annals of Clinical Microbiology and Antimicrobials 2013, 12:24  doi:10.1186/1476-0711-12-24

Published: 5 September 2013

Abstract

Background

The Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) was designed to monitor in vitro antimicrobial susceptibility to tigecycline and comparator agents. We present susceptibility data on Gram-negative organisms collected between 2005 and 2011 from nine United States census regions.

Methods

T.E.S.T. was conducted using standardized CLSI methodologies or FDA-approved breakpoints.

Results

Tigecycline was highly active (MIC90 ≤ 2 mg/L) against Enterobacteriaceae irrespective of species or region of collection (N = 25011). The isolates were also highly susceptible to the carbapenems when all regional data are combined, except for ESBL-producing Klebsiella pneumoniae (MIC90 16 mg/L) and Acinetobacter baumannii (MIC90 ≥ 32 mg/L). In addition, 883 (30%) of 2900 A. baumannii isolates were classified as multidrug-resistant (MDR): these MDR organisms were most susceptible to tigecycline (MIC90 2 mg/L) and minocycline (MIC90 8 mg/L) when all regional data are considered together. Susceptibility patterns also varied widely among the regions

Conclusions

The findings highlight the importance of monitoring antimicrobial susceptibility patterns and implementing effective methods to curb increased resistance and also confirm that additional studies to determine the efficacy of tigecycline in vivo, especially for treating infections with MDR organisms, are warranted.

Keywords:
Surveillance; Tigecycline; Resistance; USA; Census regions