title: Antimicrobial activity of tigecycline and comparative agents against clinical isolates of staphylococci and enterococci from ICUs and general hospital wards at three Swedish university hospitals.
abstract: The activities of tigecycline and comparative agents on staphylococci and enterococci isolated from patients at general hospital wards (GHWs) and intensive care units (ICUs) at 3 university hospitals in Sweden were investigated. Oxacillin disc diffusion and minimal inhibitory concentration with E-test were used. The presence of mecA, vanA or vanB genes was determined with PCR. Statistically significant higher incidence of clindamycin, fusidic acid, rifampicin and multidrug-resistant CoNS was found at ICUs compared to GHWs. Resistance rates were low among S. aureus. Tigecycline, linezolid and vancomycin were the only agents with high activity against methicillin-resistant S. aureus and multidrug-resistant CoNS. Resistance rates were low among E. faecalis, except for high-level gentamicin-resistant (HLGR) E. faecalis. E. faecium showed high resistance rates to ampicillin, piperacillin/tazobactam and imipenem. The HLGR rates among E. faecium were lower than the rates for E. faecalis. Tigecycline and linezolid were the only drugs with high activity against all enterococci including vancomycin-resistant enterococci. No statistically significant differences in susceptibility rates were found between the ward levels for S. aureus and enterococcal isolates and no statistically significant differences were found between the hospitals.
authors.affiliation: Clinical Microbiology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linkoping University, Linkoping, Sweden. carcl@imk.liu.se
authors.forename: Carina
authors.initials: C
authors.lastname: Claesson
authors.forename: Lennart E
authors.initials: LE
authors.lastname: Nilsson
authors.forename: Göran
authors.initials: G
authors.lastname: Kronvall
authors.forename: Mats
authors.initials: M
authors.lastname: Walder
authors.forename: Mikael
authors.initials: M
authors.lastname: Sörberg
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D019729:Carbon-Oxygen Ligases / Q000235:genetics; D016983:Enterococcus / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D016106:Methicillin Resistance / Q000235:genetics; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000031:analogs & derivatives* / Q000494:pharmacology; D010362:Patients' Rooms; D016133:Polymerase Chain Reaction; D013210:Staphylococcus / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D018709:Statistics, Nonparametric; D013548:Sweden; D000078304:Tigecycline; D020713:Vancomycin Resistance / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C071437:VanA ligase, Bacteria; C079913:VanB protein, Enterococcus; D000078304:Tigecycline; D019729:Carbon-Oxygen Ligases; D008911:Minocycline