title: Tigecycline therapy for carbapenem-resistant Klebsiella pneumoniae (CRKP) bacteriuria leads to tigecycline resistance.
abstract: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an increasing global threat. Here, we describe the prevalence and impact of tigecycline use in a cohort of patients with CRKP bacteriuria nested within a multicentre, prospective study. In the 21-month study period, 260 unique patients were included. Tigecycline was given to 80 (31%) patients. The use of tigecycline during the index hospitalization was significantly associated with the subsequent development of tigecycline resistance in the same patient (OR, 6.13; 95% CI, 1.15-48.65; p 0.03). In conclusion, the use of tigecycline with CRKP bacteriuria is common, and is associated with the subsequent development of tigecycline resistance.
authors.affiliation: Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: D
authors.initials: D
authors.lastname: van Duin
authors.forename: E D
authors.initials: ED
authors.lastname: Cober
authors.forename: S S
authors.initials: SS
authors.lastname: Richter
authors.forename: F
authors.initials: F
authors.lastname: Perez
authors.forename: M
authors.initials: M
authors.lastname: Cline
authors.forename: K S
authors.initials: KS
authors.lastname: Kaye
authors.forename: R C
authors.initials: RC
authors.lastname: Kalayjian
authors.forename: R A
authors.initials: RA
authors.lastname: Salata
authors.forename: S R
authors.initials: SR
authors.lastname: Evans
authors.forename: V G
authors.initials: VG
authors.lastname: Fowler
authors.forename: R A
authors.initials: RA
authors.lastname: Bonomo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001437:Bacteriuria / Q000188:drug therapy* / Q000382:microbiology; D015780:Carbapenems / Q000494:pharmacology; D015331:Cohort Studies; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D008969:Molecular Sequence Data; D017422:Sequence Analysis, DNA; D000078304:Tigecycline
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D004269:DNA, Bacterial; D000078304:Tigecycline; D008911:Minocycline
keywords: Carbapenem-resistant Enterobacteriaceae; multidrug resistance; urinary tract infection