Tigecycline Susceptibility of Carbapenem Resistant Enterobacteriaceae and Acinetobacter spp. isolates from Respiratory Tract: ATertiary Care Centre Study

摘要

Background: Tigecycline is used as a last line of defence against Multidrug Resistant (MDR) strains, and increasing rates of resistance are a growing concern globally. Tigecycline resistance has been reported in various pathogens including Acinetobacter spp., Klebsiella spp., Enterobacter spp., E. faecalis, S. aureus, S. pneumoniae and Serratia marcescens. Aim and Objectives: To study Tigecycline susceptibility pattern of isolates of Enterobacteriaceae and Acinetobacter spp. from Respiratory Tract Infections (RTI) in a tertiary care hospital. Material and Methods: A total of 7573 respiratory samples were received in Microbiology Department of Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER) from 1st January 2018 to 31st December 2018. The samples were processed as per standard techniques. Identification and antimicrobial susceptibility testing was done by VITEK-2 Compact automated system and Kirby - Bauer Disc Diffusion Method as per CLSI Guidelines. Results: Out of total 7573 respiratory samples received in laboratory, 1017 (13.42%) were culture positive for pathogens. Klebsiella pneumoniae 420( 41.29%) was predominantly isolated microorganism followed by Pseudomonas aeruginosa 206( 20.25%) and Acinetobacter spp. 193(18.97%). Most of Gram negative organisms were resistant to commonly used antibiotics. Carbapenem resistance was observed as 67.25%. Conclusion: Overall Tigecycline resistance among Carbapenem Resistant Enterobacteriaceae (CRE) and Carbapenem Resistant Acinetobacter (CRA) was found to be 15.50% and 10.69% respectively. Although Tigecycline is a promising antibiotic for the treatment of infections caused by drug resistant problematic pathogens, Tigecycline resistance is most frequently observed in A. baumannii and Enterobacteriaceae, especially in MDR strains. Hence, we advocate judicious use of Tigecycline in MDR infections and it should be kept as reserve.