1258. Methicillin-resistant Staphylococcus aureus Epidemiology and Clinical Response in Tigecycline Clinical Trials
Session: Poster Abstract Session: Staphylococcal Resistance and Epidemiology
Saturday, October 22, 2011
Room: Poster Hall B1
  • TY110200 MRSA Activity-IDSA11 Final.pdf (765.5 kB)
  • Background: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common pathogens causing skin infections. Tigecycline (TGC) is an expanded broad-spectrum glycylcycline approved for the treatment of complicated skin and skin structure infections (cSSSI) excluding DFI. The current investigation examined the infection epidemiology and clinical response of patients with MRSA cSSSI or diabetic foot infection (DFI) within the TGC clinical trials.

    Methods: Data from patients hospitalized with a cSSSI or DFI and with a baseline MRSA infection from six TGC clinical trials were pooled and examined. Baseline MRSA isolates from cSSSI and DFI were characterized by Staphylococcal cassette chromosome mec (SCCmec) type and Panton-Valentine leukocidin (PVL) status. The epidemiology of infections associated with SCCmec type IV (i.e. community-associated MRSA [caMRSA] vs. other SCCmec types (non-caMRSA) was compared.

    Results: 378 MRSA skin infections were identified, including 158 DFI, (65.9% type IV, 33.6% other types, missing 0.5%). Subjects with caMRSA compared with non-caMRSA were younger (48 vs. 55), more likely to be male, white, and reside in the USA (65% vs. 32%). Clinical infections with caMRSA were more likely to be spontaneous infections (43.4% vs. 23.6%) resulting in major abscesses (37.0% vs. 13.4%), carry the PVL gene (65.1% vs. 3.9%), and less likely to be polymicrobial (23.7% vs. 40.9%). Therapy duration (9.0 vs. 10.5 days) and length of stay (12.7 vs. 21.9 days) were shorter in caMRSA cSSSI but not in caMRSA DFI versus non-caMRSA DFI infections. Clinical efficacy between evaluable TGC and comparator (COM) subjects was similar for MRSA (TGC 76.0% vs. 75.0%), for caMRSA (71% vs. 75%) and caMRSA/PVL+ status (73% vs. 76%).

    Conclusion: caMRSA clinical presentations were different from infections with other SCCmec types however TGC was effective in the treatment of MRSA infections regardless of SCCmec type or PVL status.

    Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

    Paul McGovern, Michele Wible, Tim Babinchak and Alvaro Quintana, Pfizer Inc., Collegeville, PA


    P. McGovern, Pfizer Inc.: Employee, Salary

    M. Wible, Pfizer Inc: Employee, Salary

    T. Babinchak, Pfizer Inc.: Employee, Salary

    A. Quintana, Pfizer Inc.: Employee, Salary

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