title: Antimicrobial susceptibility among bacterial isolates from ICU and non-ICU setting and different age groups: results from the tigecycline evaluation and Surveillance trial in North America.
abstract: As part of the tigecycline evaluation and Surveillance trial (t.e.S.t.), isolates were collected from centers in North America. In vitro activity was assessed for isolates collected in 2006 using ClSi guidelines and ClSi or FDA interpretive criteria. Data were analyzed according to intensive care unit (iCU) or non-iCU location and age group (18-64 years and > 65 years).Rates of mRSA in 2006 were higher among isolates from patients aged >65 years (52.0%) than younger patients (48.4%) and from non-iCU settings (48.0%) than from the iCU (45.3%). Rates of vancomycin-resistant E. faecium, multidrug-resistant Acinetobacter spp. (resistant to levofloxacin and amikacin as well as the carbapenems and/or third generation cephalosporins), and eSbl-producing K. pneumoniae among isolates collected from the iCU were 70.7%, 5.8%, and 16.6%, respectively.Tigecycline, linezolid and vancomycin were active against all isolates of S. aureus, including mRSA, from both settings and the two age groups. Among E. faecium, >95% of isolates were susceptible to linezolid, and tigecycline maintained MIC(90)s of 0.06-0.12 mg/l. Against Acinetobacter spp., the most active antimicrobials were tigecycline and minocycline irrespective of age group or patient setting (MIC(90)s 2 and 8 mg/l, respectively). Percentage susceptibility off K. pneumoniae was >90% against tigecycline, imipenem, meropenem, cefepime and amikacin for isolates from both age groups and settings. Against eSbl-producing K. pneumoniae, imipenem (88.9%-96.4%) and tigecycline (85.1%-100%) demonstrated the highest rates of activity. tigecycline demonstrated excellent activity against clinically relevant resistant organisms.
authors.affiliation: Department of Microbiology, Mount Sinai Hospital and University of Toronto, ON, Canada. dlow@mtsinai.on.ca
authors.forename: D E
authors.initials: DE
authors.lastname: Low
authors.forename: M J
authors.initials: MJ
authors.lastname: Markovic
authors.forename: M J
authors.initials: MJ
authors.lastname: Dowzicky
mesh_terms: D000150:Acinetobacter / Q000187:drug effects; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000900:Anti-Bacterial Agents; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D016984:Enterococcus faecium / Q000187:drug effects; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007711:Klebsiella pneumoniae / Q000187:drug effects; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D008911:Minocycline / Q000031:analogs & derivatives*; D011159:Population Surveillance; D013211:Staphylococcus aureus / Q000187:drug effects; D000078304:Tigecycline
chemical_list: D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline