1295. Abstract/Poster Title: Tigecycline in vitro Activity against Carbapenem-Resistant Enterobacteriaceae (CRE) from Europe –TEST Data 2004-2012
Session: Poster Abstract Session: Below the Diaphragm
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDSA 1295.pdf (409.8 kB)
  • Background: Resistance rates of carbapenems are increasing against the Enterobacteriaceaeleaving fewer therapeutic options and serious healthcare concerns due to higher associated mortality rates among those with CRE. The Tigecycline Evaluation Surveillance Trial (TEST) program has monitored the activity of tigecycline and comparative antimicrobial agents against respiratory infections since 2004.

    Methods: 434 CRE were analyzed from a collection of >45,000 Enterobacteriaceaefrom 1,029 cumulative sites in 26 countries during 2004-2010. Carbapenem resistance was determined by imipenem or meropenem susceptibility. MICs were determined by broth microdilution, and interpreted using current EUCAST guidelines.

    Results:

    In vitro%Susceptible of CRE isolates:

    Organism / ESBL phenotype

    TIG

    A/C

    AK

    CAX

    CAZ

    CEP

    LVX

    IMP

    MER

    MIN

    P/T

    Enterobacteriaceae (434)

    74

    0

    24

    1

    0

    1

    7

    0

    0

    0

    2

    ALL ESBL+ (73)

    74

    0

    15

    0

    0

    0

    0

    --

    0

    0

    0

    E. aerogenes (17)

    65

    0

    47

    0

    0

    0

    18

    0

    0

    0

    6

    E. cloacae (64)

    69

    0

    53

    2

    0

    5

    22

    0

    0

    0

    6

    E. coli (9)

    89

    0

    44

    11

    0

    0

    22

    0

    0

    0

    0

    ESBL+ (0)

    --

    --

    --

    --

    --

    --

    --

    --

    --

    --

    --

    ESBL- (9)

    89

    0

    44

    11

    0

    0

    22

    0

    0

    0

    0

    K. oxytoca (4)

    75

    25

    50

    25

    0

    25

    25

    --

    0

    0

    25

    ESBL+ (1)

    0

    0

    0

    0

    0

    0

    0

    --

    0

    0

    0

    ESBL- (3)

    100

    33

    67

    33

    0

    33

    33

    --

    0

    0

    33

    K. pneumoniae (319)

    75

    0

    16

    0

    0

    0

    2

    0

    0

    0

    0

    ESBL+ (72)

    75

    0

    15

    0

    0

    0

    0

    --

    0

    0

    0

    ESBL- (247)

    75

    0

    16

    0

    0

    0

    2

    0

    0

    0

    0.4

    S. marcescens (15)

    87

    0

    26

    0

    0

    0

    13

    --

    0

    0

    13

    TIG, tigecycline; A/C, amoxicillin/clavulanic acid; AK, amikacin; CAX, ceftriaxone; CAZ, ceftazidime; LVX, levofloxacin; MIN, minocycline; P/T, piperacillin tazobactam. CPE, cefepime; -- no CREs detected.

    * Species with n<10 are not shown.

    Conclusion:

    • The carbapenem resistance rate in Europe has steadily increased from 0% in 2004 to 2.0% in 2012 (p<0.0001). The vast majority, 74%, of all CREs were seen in K. pneumoniae.
    • Only amikacin and tigecycline retained in vitro activity against CREs with activity >60% susceptible. Tigecycline’s % susceptible of 74% for all Enterobacteriaceae and ESBL producing strains was the highest of all antimicrobial agents in this study. This compares to a % susceptible of 93% when using the CLSI BP of ≤ 2 µg/ml.
    • Tigecycline demonstrated potent in vitro activity against CREs from a global population of Enterobacteriaceae from all respiratory sources.
    Douglas Biedenbach, BS1, Sam Bouchillon, MD2, Meredith Hackel, PhD, MPH3, Stephen Hawser, PhD4, Daryl Hoban, PhD2 and Heidi Leister-Tebbe, BS5, (1)Ihma Inc., Schaumburg, IL, (2)Ihma, Inc., Schaumburg, IL, (3)International Health Management Associates, Inc., Schaumburg, IL, (4)IHMA Europe Sārl, Epalinges, Switzerland, (5)Pfizer Inc., Collegeville, PA

    Disclosures:

    D. Biedenbach, None

    S. Bouchillon, None

    M. Hackel, None

    S. Hawser, None

    D. Hoban, None

    H. Leister-Tebbe, Pfizer Inc.: Employee, Salary

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