title: Resistance mechanisms and epidemiology of multiresistant pathogens in Europe and efficacy of tigecycline in observational studies.
abstract: OBJECTIVE
  Antimicrobial drug resistance is a growing problem in Europe and, even with differences in epidemiology, it is of great concern. The treatment of complicated skin and soft-tissue infections (cSSTIs) and complicated intra-abdominal infections (cIAIs) is hindered further by pathogens that are resistant to methicillin, carbapenems, third-generation cephalosporins and glycopeptides.
  
  
  METHODS
  An analysis of the microbiological results from five European observational studies (July 2006 to October 2011) evaluating the efficacy of tigecycline (prescribed as monotherapy or in combination with other antibacterials) for the treatment of cSSTI and cIAI is presented.
  
  
  RESULTS
  In total, 213 cSSTI and 623 cIAI patients were included; 34.4% and 56.6%, respectively, were critically ill in intensive care units. At baseline, at least one pathogen was isolated in 167 (78.4%) cSSTI and 464 (74.5%) cIAI patients, and 32.9% and 49.1% of infections were polymicrobial. In cSSTI, Staphylococcus aureus and Escherichia coli (52.7% and 18.0%, respectively) were the most frequently isolated pathogens, whereas in cIAI most infections were due to E. coli (41.8%), Enterococcus faecium (40.1%) and Enterococcus faecalis (21.1%). Clinical response was observed in >80% of patients with E. coli in both cIAI and cSSTI. In cSSTI patients, the clinical response rate to S. aureus was 80.8%. For cIAI, 77.4% of E. faecium and 79.5% of E. faecalis patients responded to treatment.
  
  
  CONCLUSIONS
  Tigecycline when given alone or in combination with other antibacterials appeared to be efficacious against multiple pathogens, affirming its role in real-life clinical practice as a broad-spectrum antibacterial for the treatment of patients with cSSTI and cIAI, including the critically ill, across Europe.
authors.affiliation: Center for Microbiology and Infectious Diseases, Berlin, Germany. wrheizmann@aol.com
authors.forename: Wolfgang R
authors.initials: WR
authors.lastname: Heizmann
authors.forename: Hervé
authors.initials: H
authors.lastname: Dupont
authors.forename: Philippe
authors.initials: P
authors.lastname: Montravers
authors.forename: Xavier
authors.initials: X
authors.lastname: Guirao
authors.forename: Christian
authors.initials: C
authors.lastname: Eckmann
authors.forename: Matteo
authors.initials: M
authors.lastname: Bassetti
authors.forename: Miguel Sánchez
authors.initials: MS
authors.lastname: García
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Capparella
authors.forename: Damien
authors.initials: D
authors.lastname: Simoneau
authors.forename: Klaus Friedrich
authors.initials: KF
authors.lastname: Bodmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination / Q000379:methods; D005060:Europe; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D059413:Intraabdominal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D017192:Skin Diseases, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D000078304:Tigecycline; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline
keywords: broad-spectrum antibacterial therapy; complicated intra-abdominal infections; complicated skin and soft-tissue infections; non-interventional studies; polymicrobial infections