A longitudinal assessment of antimicrobial susceptibility among important pathogens collected as part of the Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) in France between 2004 and 2012.

Vincent Cattoir,Michael J Dowzicky

doi:10.1186/2047-2994-3-36

Abstract

BackgroundClinically important Gram-positive and -negative isolates were collected from patients in France between 2004 and 2012 as a part of the Tigecycline Evaluation and Surveillance Trial.MethodsMICs were determined using methodology described by the Clinical and Laboratory Standards Institute.ResultsIn total, 17,135 isolates were contributed by 29 medical centres; respiratory (25.1%) and cardiovascular (20.3%) sources predominated. High susceptibility was observed among Enterococcus spp. and Staphylococcus aureus (including methicillin-resistant S. aureus [MRSA]) to linezolid (100%), tigecycline (≥99.8%) and vancomycin (≥94.6%). The percentage of MRSA decreased from 34.3% in 2004 to 20.0% in 2009 before increasing to 34.7% in 2012. Vancomycin, linezolid, levofloxacin and carbapenems were highly active (≥99.6%) against Streptococcus pneumoniae; 3.2% were PRSP. Escherichia coli showed peak susceptibility to the carbapenems (≥99.9%), tigecycline (99.3%) and amikacin (97.9%); significant (p < 0.01) decreases in susceptibility were observed for ampicillin, cefepime and ceftriaxone between 2004 and 2012. ESBL production among E. coli increased from 3.0% (2004) to 14.9% (2012). High susceptibility was noted among Haemophilus influenzae to levofloxacin (100%), amoxicillin-clavulanate (99.2%), carbapenems (≥98.7%) and ceftriaxone (98.5%); β-lactamase production fluctuated with no notable trend between 18.1% (2007) and 27.7% (2011). Klebsiella spp. were highly susceptible to carbapenems (≥99.6%) and amikacin (≥96.4%); significant (p < 0.01) decreases in amoxicillin-clavulanate, cefepime, ceftriaxone, levofloxacin, piperacillin-tazobactam and tigecycline susceptibility were observed among K. pneumoniae between 2004 and 2012. Only imipenem was highly active (96.5% susceptible) against Acinetobacter baumannii. Imipenem and amikacin (87.7% and 87.1% susceptible) were the most active agents against P. aeruginosa; 10.2% of isolates were categorized as multidrug resistant.ConclusionsCarbapenems, linezolid, tigecycline and vancomycin conserved good in vitro activity against most pathogens (according to their spectrum of activity) in France between 2004 and 2012.Electronic supplementary materialThe online version of this article (doi:10.1186/2047-2994-3-36) contains supplementary material, which is available to authorized users.

Highlights

Important Gram-positive and -negative isolates were collected from patients in France between 2004 and 2012 as a part of the Tigecycline Evaluation and Surveillance Trial
Tigecycline is a broad-spectrum antimicrobial agent which has been indicated for use in the treatment of complicated skin and skin structure infections and complicated intra-abdominal infections [5]
We examine the activity of tigecycline and comparators against clinically important Gram-positive and Gram-negative pathogens collected from community and nosocomial patients in France between 2004 and 2012

Summary

Introduction

Important Gram-positive and -negative isolates were collected from patients in France between 2004 and 2012 as a part of the Tigecycline Evaluation and Surveillance Trial. Several programmes have been initiated to combat these increasing levels of resistance, including measures to control transmission of resistant pathogens, to promote the use of alcohol-based hand-rub solution in hospitals, to control/prevent the spread of emerging multidrug-resistant (MDR) organisms (i.e., vancomycinresistant enterococci [VRE], carbapenemase-producing Enterobacteriaceae) and to decrease antibiotic consumption [4] These efforts have paid at least some dividends: declining levels of antimicrobial resistance have been reported in recent years among French isolates of Streptococcus pneumoniae to penicillin (from 36.2% in 2005 to 23.4% in 2012) and Staphylococcus aureus to methicillin (from 33.4% in 2001 to 19.1% in 2012) [3]. This manuscript serves as an update to Rodloff et al [6], who described a collection of isolates from France, Germany, Italy, Spain and the U.K. collected as a part of T.E.S.T. between 2004 and 2006, as well as NørskovLauritsen et al [7], who presented data on European isolates (including France) collected between 2004 and 2007

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Conclusion