title: Characteristics of superinfections during treatment with tigecycline.
abstract: Tigecycline has a broad-spectrum in vitro activity against Gram-positive and Gram-negative bacteria, including multidrug-resistant (MDR) strains. However, some Gram-negative bacteria are intrinsically resistant or have reduced susceptibility to tigecycline. We performed a prospective, observational study of 43 patients who received tigecycline as the treatment for serious infections due to MDR Gram-negative microorganisms, to evaluate superinfections. In 60.5% of our patients, tigecycline-resistant (T-R) Gram-negative microorganisms were isolated, representing superinfection in 37.2% and colonization in 23.5%. Pseudomonas aeruginosa was the predominant pathogen (48.4%) followed by Providencia stuartii, Proteus mirabilis and Stenotrophomonas maltophilia. Median time elapsed between tigecycline prescription and isolation of T-R pathogens was 7 days. The 16 superinfections consisted of ventilator-associated pneumonias (43.75%), catheter-related bloodstream infections (37.5%), intra-abdominal infections (12.5%) and urinary tract infection (6.25%). Attributed mortality to superinfections was 31.25%. The comparison of various potential risk factors for isolation of T-R microorganisms did not reveal statistically significant results.
authors.affiliation: a Intensive Care Unit , Konstantopouleio General Hospital , Athens , Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Katsiari
authors.affiliation: a Intensive Care Unit , Konstantopouleio General Hospital , Athens , Greece.
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Ntorlis
authors.affiliation: a Intensive Care Unit , Konstantopouleio General Hospital , Athens , Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Nteves
authors.affiliation: b Department of Microbiology , Konstantopouleio General Hospital , Athens , Greece.
authors.forename: Zoi
authors.initials: Z
authors.lastname: Roussou
authors.affiliation: b Department of Microbiology , Konstantopouleio General Hospital , Athens , Greece.
authors.forename: Evangelia D
authors.initials: ED
authors.lastname: Platsouka
authors.affiliation: a Intensive Care Unit , Konstantopouleio General Hospital , Athens , Greece.
authors.forename: Asimina
authors.initials: A
authors.lastname: Maguina
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy; D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012307:Risk Factors; D015163:Superinfection / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D000078304:Tigecycline
chemical_list: D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline
keywords: Critically ill patients; attributed mortality; combination therapy; multi-drug resistant Gram-negative bacteria; risk factors; superinfections; tigecycline