Emergence of tigecycline-resistant Klebsiella pneumoniae after tigecycline therapy for complicated urinary tract infection caused by carbapenem-resistant Escherichia coli

摘要

We read with interest the article by Arya et al. on the emergence of tigecycline resistance amongst multi-drug resistant gram negative isolates in a multi-disciplinary hospital.1 Complicated urinary tract infections (cUTIs) tend to be caused by Enterobacteriaceae species that are resistant to beta-lactam antibiotics.2 Tigecycline is a mino-cycline derivative that demonstrates good in vitro activity against multidrug-resistant or carbapenem-resistant bacteria.3 Tigecycline is indicated for the treatment of intra-abdominal infections, skin and soft-tissue infections, and acute bacterial community-acquired pneumonia. However, clinical use of tigecycline in treatment of cUTIs remains controversial particularly when levels in urine are likely subtherapeutic.