Resistance among Klebsiella pneumoniae to most antibiotics is on the rise. Tigecycline has been considered as one of the few therapeutic options available to treat multidrug-resistant bacteria.
We investigated the clinical and microbiological characteristics of tigecycline non-susceptible K. pneumoniae bacteremia.
Methods:
Adult patients with tigecycline non-susceptible K.
pneumoniae bacteremia at a medical center in Taiwan over a 3-year period were enrolled. K.
pneumoniae isolates were identified by the E-test using criteria set by the US Food and Drug Administration (FDA). Data on the clinical features of patients were collected from medical records.
Genes for beta-lactamases, antimicrobial susceptibilities and pulsed-field gel electrophoresis (PFGE) results were determined for all isolates.
Results:
Of 36 patients, 27 had nosocomial bacteremia. Overall 28-day mortality was 38.9%.
The MIC50 and MIC90 of tigecycline were 6 and 8 mg/L, respectively. No carbapenemase was detected among the 36 isolates.
Twenty isolates carried extended spectrum beta-lactamases and/or DHA-1 genes. No major cluster of isolates was found among the 36 isolates by PFGE.
Intensive care unit onset of tigecycline non-susceptible Klebsiella pneumoniae bacteremia was the only independent risk factor for 28-day mortality.
Conclusions:
The high mortality of patients with tigecycline non-susceptible K. pneumoniae bacteremia may suggest a critical problem.
Further study to identify the possible risk factors for its development and further investigation of this type of bacteremia is necessary.
Author: Yi-Tsung LinFu-Der WangYu-Jiun ChanYung-Chieh FuChang-Phone Fung
Credits/Source: BMC Infectious Diseases 2014, 14:1
Published on: 2014-01-01
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