Abstract

BackgroundWe report here on 14438 Streptococcus pneumoniae and 14770 Haemophilus influenzae isolates collected from 560 centres globally between 2004 and 2012 as a part of the Tigecycline Evaluation and Surveillance Trial (T.E.S.T.).MethodsMIC testing was performed using broth microdilution methods as described by the Clinical and Laboratory Standards Institute (CLSI) using CLSI-approved breakpoints; US Food and Drug Administration breakpoints were used for tigecycline as CLSI breakpoints are not available.ResultsAt least 99% of S. pneumoniae isolates globally were susceptible to levofloxacin, linezolid, tigecycline or vancomycin. Penicillin resistance was observed among 14.8% of S. pneumoniae and was highest in Asia/Pacific Rim (30.1%) and Africa (27.6%); 23.4% of S. pneumoniae isolates were penicillin-intermediate, which were most common in Africa (37.6%). Minocycline susceptibility among S. pneumoniae decreased by 20% between 2004-2008 and 2009-2012. High (>98.5%) susceptibility was reported among H. influenzae to all antimicrobial agents on the T.E.S.T. panel excluding ampicillin, to which only 78.3% were susceptible. β-lactamase production was observed among 20.2% of H. influenzae isolates; 1.5% of isolates were β-lactamase negative, ampicillin-resistant.ConclusionsS. pneumoniae remained highly susceptible to levofloxacin, linezolid, tigecycline and vancomycin while H. influenzae was susceptible to most antimicrobial agents in the testing panel (excluding ampicillin).Electronic supplementary materialThe online version of this article (doi:10.1186/s12941-014-0052-2) contains supplementary material, which is available to authorized users.

Highlights

  • We report here on 14438 Streptococcus pneumoniae and 14770 Haemophilus influenzae isolates collected from 560 centres globally between 2004 and 2012 as a part of the Tigecycline Evaluation and Surveillance Trial (T.E.S.T.)

  • S. pneumoniae was highly susceptible to vancomycin (100%), linezolid (>99.9%), tigecycline (99.9%), and levofloxacin (>98.9%) (Additional file 1: Table S1)

  • This reflects the findings of the European Antimicrobial Resistance Surveillance Network (EARS-Net), who showed that non-susceptibility among invasive S. pneumoniae in Europe has remained stable between 2004 and 2011, large variations existed between countries [1]

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Summary

Introduction

We report here on 14438 Streptococcus pneumoniae and 14770 Haemophilus influenzae isolates collected from 560 centres globally between 2004 and 2012 as a part of the Tigecycline Evaluation and Surveillance Trial (T.E.S.T.). European guidelines are available [4], while several European countries have established their own policies regarding the treatment of CAP including the UK [5], Sweden [6] and the Netherlands [7]. In 2009, the US Food and Drug Administration approved tigecycline for the treatment of community-acquired bacterial pneumonia (CABP) caused by Streptococcus pneumoniae (penicillin-susceptible isolates), including cases with concurrent bacteremia, Haemophilus influenzae (β-lactamase negative isolates), and Legionella pneumophila in the USA [10], based in part on results from a pair of Phase III clinical trials comparing the efficacy of tigecycline and levofloxacin in hospitalized patients with CABP [11]. We examine susceptibility trends among isolates of S. pneumoniae and H. influenzae collected from Africa, the Asia/Pacific Rim, Europe, Latin America, the Middle East and North America between 2004 and 2012

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