Analysis and Evaluation of in vitro Antimicrobial Susceptibility Test for Tigecycline_West China Medical Journal

Authors：

 ShuLing , DengJin , WuSiying ,  KangMei

Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

KangMei, Email: 1285214942@qq.com

Keywords：

Tigecycline; Acinetobacter baumannii; Enterobacteriaceae; Antimicrobial susceptibility test

DOI：

10.7507/1002-0179.201600467

Video：

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Objective To detect the in vitro susceptibility of common clinical multidrug-resistant bacteria to tigecycline by disk diffusion (KB), minimum inhibitory concentrations (MIC) test strip (MTS) and Vitek 2 Compact methods, in order to evaluate the accuracy of the three different susceptibility testing methods. Methods A total of 140 multidrug-resistant isolates (excluding Pseudomonas aeruginosa) were collected retrospectively from West China Hospital between January 2014 and March 2015. The inhibitory zone diameters and MIC of tigecycline were determined by KB, Vitek 2 Compact system and MTS respectively. The results of Vitek 2 Compact system and KB method were compared with that of MTS. Results Among the 140 multidrug-resistant isolates, 119 were Acinetobacter baumannii, and 21 were Enterobacteriaceae. According to the US Food and Drug Administration standards, the sensitivity rates of 119 Acinetobacter baumannii isolates to tigecycline were 88.2%, 85.7%, and 90.8% respectively for KB method, Vitek 2 Compact system and MTS, and those of 21 Enterobacteriaceae were 76.2%, 81.0%, and 81.0%, respectively. Conclusions Tigecycline displays effective in vitro antibacterial activity to clinical common multidrug-resistant bacteria (excluding Pseudomonas aeruginosa), but different susceptibility testing methods have shown different susceptibility rates. For Acinetobacter baumannii, KB method is superior to Vitek 2 Compact system, and for Enterobacteriaceae, Vitek 2 Compact system is superior to KB method.

Citation： ShuLing, DengJin, WuSiying, KangMei. Analysis and Evaluation of in vitro Antimicrobial Susceptibility Test for Tigecycline. West China Medical Journal, 2016, 31(10): 1697-1700. doi: 10.7507/1002-0179.201600467 Copy

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5.	王輝, 倪語星, 陳民鈞, 等.新型甘氨酰環素類抗菌藥物替加環素的體外藥敏試驗操作規程[J].中華檢驗醫學雜志, 2009, 32(11): 1208-1213.
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8.	張冀霞, 趙春江, 劉文云, 等.替加環素對鮑曼不動桿菌和肺炎克雷伯菌體外抗菌活性檢測的影響因素和方法學評估[J].中華檢驗醫學雜志, 2013, 36(7): 604-609．.
9.	杜小幸, 王海薄, 傅鷹, 等.不同藥敏方法檢測替加環素對鮑曼不動打菌敏感性的比較[J].中華檢驗醫學雜志, 2013, 36(7): 598-603.
10.	Zarkotou O, Pournaras S, Altouvas G, et al. Comparative evaluation of tigecycline susceptibility testing methods for expanded-spectrum cephalosporin-and carbapenem-resistant gram-negative pathogens[J]. J Clin Microbiol, 2012, 50(11): 3747-3750.
11.	Torrico M, González N, Giménez MJ, et al. Influence of media and testing methodology on susceptibility to tigecycline of Enterobacteriaceae with reported high tigecycline MIC[J]. J Clin Microbiol, 2010, 48(6): 2243-2246.
12.	Lat A, Clock SA, Wu F, et al. Comparison of polymyxin B, tigecycline, cefepime, and meropenem MICs for KPC-producing Klebsiella pneumoniae by broth microdilution, Vitek 2, and Etest[J]. J Clin Microbiol, 2011, 49(5): 1795-1798.
13.	Curcio D, Fernández F. Comment on: effect of different Mueller-Hinton agars on tigecycline disc diffusion susceptibility for acinetobacter spp[J]. J Antimicrob Chemother, 2008, 62(5): 1166-1167.
14.	Liu JW. Jang TN, Cheng YJ, et al. Comparison of the E-test and broth microdilution method for tigecycline susceptibility testing against clinical isolates of Acinetobacter baumarmii from Taiwan[J]. Int J Antimicrob Agents, 2010, 35(2): 201-202.
15.	Liu JW, Ko WC, Huang CH, et al. Agreement assessment of tigecycline susceptibilities determined by the disk diffusion and broth microdilution methods among commonly encountered resistant bacterial isolates: results from the Tigecycline In Vitro Surveillance in Taiwan (TIST) study, 2008[J]. Antimicrob Agents Chemother, 2012, 56(3): 1414-1417.
16.	閆少珍, 宋玥, 陳中舉, 等. 4種方法檢測替加環素對鮑曼不動桿菌和腸桿菌科細菌體外藥敏結果分析[J].中華微生物學和免疫學雜志, 2014, 34(11): 859-862.
17.	Tejero R, Causse M, Moreno M, et al. Evaluation of the variability in the susceptibility of Acinetobacter baumannii to tigecycline in the same medium with two methods of quantitative diffusion different commercial[J]. Rev Esp Quimioter, 2012, 25(3): 189-193.
18.	Hope R, Mushtaq S, James D, et al. Tigecycline activity: low resistance rates but problematic disc breakpoints revealed by a multicentre sentinel survey in the UK[J]. J Antimicrob Chemother, 2010, 65(12): 2602-2609.

1. 朱德妹, 汪復, 胡付品, 等. 2010年中國CHINET細菌耐藥性監測[J].中國感染與化療雜志, 2011, 11(5): 321-329.
2. 中華人民共和國衛生部.多重耐藥菌醫院感染預防與控制技術指南(試行)[EB/OL]. (2011-01-17) [2016-03-01]. http://www.nhfpc.gov.cn/mohyzs/s3954/201101/50487.shtml.
3. Souli M, Galani I, Antoniadou A, et al. An outbreak of infection due to beta-Lactamase Klebsiella pneumoniae Carbapenemase 2-producing K. pneumoniae in a Greek university hospital: molecular characterization, epidemiology, and outcomes[J]. Clin Infect Dis, 2010, 50(3): 364-373.
4. CLSI. Performance standards for antimicrobial disk susceptibility tests; approved standard-tenth edition. CLSI document M02-A10[S]. Wayne, PA: Clinical and Laboratory Standards Institute, 2009.
5. 王輝, 倪語星, 陳民鈞, 等.新型甘氨酰環素類抗菌藥物替加環素的體外藥敏試驗操作規程[J].中華檢驗醫學雜志, 2009, 32(11): 1208-1213.
6. 胡必杰.轉變觀念改革系統共創醫院感染"零寬容"[J].中華內科雜志, 2007, 46(9): 708-709.
7. Liao CH, Kung HC, Hsu GJ, et al. In-vitro activity of tigecycline against clinical isolates of Acinetobacter baumannii in Taiwan determined by the broth microdilution and disk diffusion methods[J]. Int J Antimicrob Agents, 2008, 32 (Suppl 3): S192-S196.
8. 張冀霞, 趙春江, 劉文云, 等.替加環素對鮑曼不動桿菌和肺炎克雷伯菌體外抗菌活性檢測的影響因素和方法學評估[J].中華檢驗醫學雜志, 2013, 36(7): 604-609．.
9. 杜小幸, 王海薄, 傅鷹, 等.不同藥敏方法檢測替加環素對鮑曼不動打菌敏感性的比較[J].中華檢驗醫學雜志, 2013, 36(7): 598-603.
10. Zarkotou O, Pournaras S, Altouvas G, et al. Comparative evaluation of tigecycline susceptibility testing methods for expanded-spectrum cephalosporin-and carbapenem-resistant gram-negative pathogens[J]. J Clin Microbiol, 2012, 50(11): 3747-3750.
11. Torrico M, González N, Giménez MJ, et al. Influence of media and testing methodology on susceptibility to tigecycline of Enterobacteriaceae with reported high tigecycline MIC[J]. J Clin Microbiol, 2010, 48(6): 2243-2246.
12. Lat A, Clock SA, Wu F, et al. Comparison of polymyxin B, tigecycline, cefepime, and meropenem MICs for KPC-producing Klebsiella pneumoniae by broth microdilution, Vitek 2, and Etest[J]. J Clin Microbiol, 2011, 49(5): 1795-1798.
13. Curcio D, Fernández F. Comment on: effect of different Mueller-Hinton agars on tigecycline disc diffusion susceptibility for acinetobacter spp[J]. J Antimicrob Chemother, 2008, 62(5): 1166-1167.
14. Liu JW. Jang TN, Cheng YJ, et al. Comparison of the E-test and broth microdilution method for tigecycline susceptibility testing against clinical isolates of Acinetobacter baumarmii from Taiwan[J]. Int J Antimicrob Agents, 2010, 35(2): 201-202.
15. Liu JW, Ko WC, Huang CH, et al. Agreement assessment of tigecycline susceptibilities determined by the disk diffusion and broth microdilution methods among commonly encountered resistant bacterial isolates: results from the Tigecycline In Vitro Surveillance in Taiwan (TIST) study, 2008[J]. Antimicrob Agents Chemother, 2012, 56(3): 1414-1417.
16. 閆少珍, 宋玥, 陳中舉, 等. 4種方法檢測替加環素對鮑曼不動桿菌和腸桿菌科細菌體外藥敏結果分析[J].中華微生物學和免疫學雜志, 2014, 34(11): 859-862.
17. Tejero R, Causse M, Moreno M, et al. Evaluation of the variability in the susceptibility of Acinetobacter baumannii to tigecycline in the same medium with two methods of quantitative diffusion different commercial[J]. Rev Esp Quimioter, 2012, 25(3): 189-193.
18. Hope R, Mushtaq S, James D, et al. Tigecycline activity: low resistance rates but problematic disc breakpoints revealed by a multicentre sentinel survey in the UK[J]. J Antimicrob Chemother, 2010, 65(12): 2602-2609.

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