title: Antimicrobial susceptibility of extended-spectrum beta-lactamase producers and multidrug-resistant Acinetobacter baumannii throughout the United States and comparative in vitro activity of tigecycline, a new glycylcycline antimicrobial.
abstract: As part of the Tigecycline Evaluation and Surveillance Trial, isolates of Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii were collected in the United States between January 2004 and January 2006. Determinations of antimicrobial susceptibility and extended-spectrum beta-lactamase (ESBL) production were carried out according to the Clinical and Laboratory Standards Institute guidelines. A high percentage of ESBL-producing K. pneumoniae (>or=19.0%) was detected in New Jersey, Massachusetts, New York, and Missouri, and for E. coli, in the District of Columbia (9.5%). Against ESBL-producing isolates, the lowest MIC(90)s were for tigecycline (0.5-2 microg/mL) and imipenem (0.5-8 microg/mL). Overall, 282 (27.5%) A. baumannii isolates were resistant to >or=3 antimicrobial classes. The most common phenotype (33.0%) was resistance to cefepime, ceftazidime, ceftriaxone, levofloxacin, and piperacillin-tazobactam. Against multidrug-resistant A. baumannii, tigecycline and minocycline were the most active agents (MIC(90), 2 and 8 microg/mL, respectively).
authors.affiliation: International Health Management Associates, Inc., Schaumburg, IL 60173-3817, USA. dhoban@ihmainc.com
authors.forename: Daryl J
authors.initials: DJ
authors.lastname: Hoban
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Bouchillon
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dowzicky
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000201:enzymology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000201:enzymology; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000031:analogs & derivatives* / Q000494:pharmacology; D011159:Population Surveillance; D000078304:Tigecycline; D014481:United States; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D001618:beta-Lactamases; D008911:Minocycline