Tigecycline antimicrobial activity tested against clinical bacteria from Latin American medical centres: results from SENTRY Antimicrobial Surveillance Program (2011–2014)
Introduction
Tigecycline was the first of a class of antimicrobials named glycylcyclines and has been active in vitro against a variety of Gram-positive and Gram-negative organisms, including meticillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Enterobacteriaceae strains that produce extended-spectrum β-lactamases (ESBLs) and carbapenemases, such as Klebsiella pneumoniae carbapenemases (KPC) and metallo-β-lactamases, and multidrug-resistant (MDR) Acinetobacter spp. [1]. Tigecycline was initially approved by the US Food and Drug Administration (FDA) in 2005 for the treatment of adults with complicated skin and skin-structure infections and complicated intra-abdominal infections [2]. In 2009, tigecycline also received FDA approval for the treatment of community-acquired bacterial pneumonia [1], [2]. This minocycline derivative has provided clinicians with an alternative treatment option for infections caused by these ‘difficult-to-treat’ pathogens [3], [4], [5], [6], [7].
A limited number of Latin American countries possess a nationwide surveillance programme for monitoring antimicrobial resistance [8], [9]. Data from monitoring surveillance programmes, such as the SENTRY Antimicrobial Surveillance Program, have provided information on the continuing activity of most clinically relevant antimicrobial agents against a wide spectrum of clinically important Gram-positive and Gram-negative pathogens from Latin America [10], [11], [12]. The objective of this investigation was to evaluate the in vitro activity of tigecycline tested against contemporary clinical isolates causing bacterial infections in Latin American medical centres. The prevalence of the most clinically important resistance phenotypes in the main Latin American countries was also evaluated.
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Bacterial strains
A total of 13,494 bacterial organisms, including 5818 (43.1%) Gram-positive cocci and 7676 (56.9%) Gram-negative bacilli, were collected between January 2011 and December 2014 from 21 Latin American medical centres located in 11 nations as part of the SENTRY Antimicrobial Surveillance Program. The number of isolates from each species/organism group collected from each country is listed in Table 1. Of note, Argentina, Brazil, Chile and Mexico contributed 78.9% of the isolates. The organisms were
Results
The in vitro activity of tigecycline tested against clinical bacteria collected from Latin American countries during the 4-year period (2011–2014) of this investigation is summarised in the format of MIC distributions (Table 2). Tigecycline was active against Gram-positive organisms, with MIC50/90 values of 0.06/0.06 µg/mL for S. aureus (2878 strains), 0.06/0.12 µg/mL for coagulase-negative staphylococci (CoNS) (880 strains), 0.06/0.06 µg/mL for enterococci (including 477 E. faecalis, 197
Discussion
The results of this investigation provide valuable information on the activity of tigecycline and various comparator agents tested against a large longitudinal collection (2011–2014) of bacterial isolates collected from Latin American medical centres, including MDR organisms that are prevalent in the region such as MRSA, VRE, ESBL-producing strains and CRE [8], [10], [11], [12], [17], [18]. However, the limitations of the study should be considered when interpreting the data, with the small
Acknowledgements
The authors would like to thank all the participants of the SENTRY Antimicrobial Surveillance Program for providing bacterial isolates.
Funding: JMI Laboratories, Inc. (North Liberty, IA) received funding for this study from Pfizer Inc. in connection with the development of this manuscript. This study was supported by Pfizer Inc. via the SENTRY Program platform.
Competing interests: JMI Laboratories, Inc. has also received research and educational grants in 2014–2015 from Achaogen, Actavis,
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