1562. In vitro activity of Tigecycline and Comparator Agents among E. coli and Klebsiella spp., Including ESBL-Producing Isolated from Nordic Countries: TEST Program 2004-2012
Session: Poster Abstract Session: Microbial and Host Genetic Factors in Disease
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDSA 1562.pdf (74.0 kB)
  • Background: Nordic countries have had lower rates of bacterial resistance to antimicrobial agents compared to other European countries based upon surveillance literature. This study documents the susceptibility of tigecycline (TIG), a glycycycline with potent activity against most enteric pathogens, and comparator agents tested against E. coli (EC), Klebsiella pneumoniae (KPN) and K. oxytoca (KOX) from Denmark, Finland, Norway and Sweden. This analysis includes the activity of these agents against strains that produce ESBL enzymes in these four Nordic countries.

    Methods: EC (944), KPN (643) and KOX (269) isolates were collected from multiple infection sources and tested for susceptibility (S) to TIG and comparators using CLSI and EUCAST breakpoint criteria during TEST 2004-2012 program. Isolates were tested in broth microdilution by CLSI methods and quality assurance using ATCC strains tested concurrently. Disk approximation testing according to CLSI was performed to confirm ESBL-producing isolates.

    Results: The table shows the %S for isolates tested from Nordic countries using CLSI, EUCAST or FDA breakpointsa.

     

    EC

    ESBL+ EC

    KSPb

    ESBL+ KPN

    ESBL+ KOX

    N

    944

    82

    918

    37

    8

    Amikacin

    99.5/98.8

    100.0/98.8

    99.9/99.5

    97.3/86.5

    100.0/100.0

    Cefepime

    93.6/89.1

    35.4/3.7

    96.1/92.5

    32.4/10.8

    50.0/37.5

    Ceftriaxone

    88.6/88.6

    1.2/1.2

    91.1/91.1

    0.0/0.0

    0.0/0.0

    Levofloxacin

    85.9/88.3

    31.7/29.3

    94.6/93.3

    45.9/43.2

    62.5/62.5

    Meropenem

    99.5/99.7

    100.0/100.0

    100.0/100.0

    100.0/100.0

    100.0/100.0

    Pip-Tazo

    96.5/95.2

    86.6/76.8

    94.4/91.5

    81.1/59.5

    62.5/62.5

    Tigecycline

    100.0/99.9

    100.0/100.0

    97.2/91.9

    91.9/78.4

    100.0/100.0

    aCLSI/EUCAST breakpoint criteria; FDA/EUCAST criteria used for TIG.

    bAll Klebsiellaspp. combined.

    The ESBL rates in these four Nordic countries were 8.7, 5.8 and 3.0% for EC, KPN and KOX, respectively. Overall ESBL rates were highest in Finland (12.1%) compared to Denmark (7.7%), Sweden (4.3%) and Norway (4.2%).

    Conclusion: Amikacin, meropenem and TIG were active against all EC, including ESBL-producing strains from these countries. Slightly lower TIG activity was observed among the Klebsiella spp. Although lower ESBL rates were observed in these Nordic countries compared to other regions of Europe from literature sources, continued monitoring of resistance remains critical to establish trends of resistance and monitor the utility of current therapeutic agents.

    Douglas Biedenbach, BS1, Ian Morrissey, PhD2, Meredith Hackel, PhD3, Daryl Hoban, PhD3, Samuel Bouchillon, MD3, Brian Johnson, BS4 and Heidi Leister-Tebbe, BS5, (1)International Health Management Associates, Inc., Schaumburg, IL, (2)IHMA Europe SÓrl, Epalinges, Switzerland, (3)Ihma, Inc., Schaumburg, IL, (4)IHMA, Inc., Schaumburg, IL, (5)Pfizer Inc., Collegeville, PA

    Disclosures:

    D. Biedenbach, None

    I. Morrissey, None

    M. Hackel, None

    D. Hoban, None

    S. Bouchillon, None

    B. Johnson, None

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

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