title: Global in vitro activity of tigecycline and comparator agents: Tigecycline Evaluation and Surveillance Trial 2004-2013.
abstract: BACKGROUND
  The Tigecycline Evaluation and Surveillance Trial (TEST) is a global antimicrobial susceptibility surveillance study which has been ongoing since 2004. This report examines the in vitro activity of tigecycline and comparators against clinically important pathogens collected globally between 2004 and 2013.
  
  
  METHODS
  Antimicrobial susceptibility was determined using guidelines published by the Clinical and Laboratory Standards Institute. The Cochran Armitage Trend Test was used to identify statistically significant changes in susceptibility between 2004 and 2013.
  
  
  RESULTS
  Among the Enterobacteriaceae susceptibility was highest to the carbapenems [imipenem 97.1% (24,655/25,381), meropenem 97.0% (90,714/93,518)], tigecycline (97.0%, 115,361/118,899) and amikacin (96.9%, 115,200/118,899). Against Acinetobacter baumannii the highest rates of susceptibility were for minocycline (84.5%, 14,178/16,778) and imipenem (80.0%, 3,037/3,795). The MIC90 for tigecycline was 2 mg/L. 40% (6,743/16,778) of A. baumannii isolates were multidrug-resistant. Enterococci were highly susceptible to tigecycline and linezolid (>99%); vancomycin resistance was observed among 2% of Enterococcus faecalis (325/14,615) and 35% of Enterococcus faecium (2,136/6,167) globally. 40% (14,647/36,448) of Staphylococcus aureus were methicillin-resistant while 15% (2,152/14,562) of Streptococcus pneumoniae were penicillin-resistant. Against S. aureus and S. pneumoniae susceptibility to linezolid, vancomycin, and tigecycline was ≥99.9%. Globally, 81% (331/410) of statistically significant susceptibility changes during the study period were decreases in susceptibility.
  
  
  CONCLUSIONS
  Amikacin, the carbapenems, and tigecycline were active against most gram-negative pathogens while linezolid, tigecycline, and vancomycin retained activity against most gram-positive pathogens collected in TEST during 2004-2013.
authors.affiliation: Department of Medical Microbiology & Infectious Disease, University of Manitoba, MS675B-820 Sherbrook Street, R3A 1R9, Winnipeg, Manitoba, Canada. dhoban@dsmanitoba.ca.|IHMA, 2122 Palmer Drive, IL 60173-3817, Schaumburg, USA. dhoban@dsmanitoba.ca.
authors.forename: Daryl J
authors.initials: DJ
authors.lastname: Hoban
authors.affiliation: Pfizer Vaccines, 23-25, avenue du Dr. Lannelongue, F-75668, Paris Cedex 14, France. RalfRene.Reinert@pfizer.com.
authors.forename: Ralf Rene
authors.initials: RR
authors.lastname: Reinert
authors.affiliation: IHMA, 2122 Palmer Drive, IL 60173-3817, Schaumburg, USA. sbouchillon@ihmainc.com.
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Bouchillon
authors.affiliation: Pfizer Inc., 500 Arcola Road; E-Dock, 19426, Collegeville, PA, USA. Michael.Dowzicky@pfizer.com.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dowzicky
mesh_terms: D000900:Anti-Bacterial Agents / Q000737:chemistry / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D004341:Drug Evaluation; D024881:Drug Resistance, Bacterial; D062665:Epidemiological Monitoring; D006801:Humans; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000031:analogs & derivatives* / Q000737:chemistry / Q000494:pharmacology; D000078304:Tigecycline
chemical_list: D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline