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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2.	中华人民共和国卫生部.多重耐药菌医院感染预防与控制技术指南(试行)[EB/OL]. (2011-01-17) [2016-03-01]. http://www.nhfpc.gov.cn/mohyzs/s3954/201101/50487.shtml.
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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.
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6.	胡必杰.转变观念改革系统共创医院感染"零宽容"[J].中华内科杂志, 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.	张冀霞, 赵春江, 刘文云, 等.替加环素对鲍曼不动杆菌和肺炎克雷伯菌体外抗菌活性检测的影响因素和方法学评估[J].中华检验医学杂志, 2013, 36(7): 604-609．.
9.	杜小幸, 王海薄, 傅鹰, 等.不同药敏方法检测替加环素对鲍曼不动打菌敏感性的比较[J].中华检验医学杂志, 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.	闫少珍, 宋玥, 陈中举, 等. 4种方法检测替加环素对鲍曼不动杆菌和肠杆菌科细菌体外药敏结果分析[J].中华微生物学和免疫学杂志, 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, 汪复, 胡付品, 等. 2010年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志, 2011, 11(5): 321-329.
2. 中华人民共和国卫生部.多重耐药菌医院感染预防与控制技术指南(试行)[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. 王辉, 倪语星, 陈民钧, 等.新型甘氨酰环素类抗菌药物替加环素的体外药敏试验操作规程[J].中华检验医学杂志, 2009, 32(11): 1208-1213.
6. 胡必杰.转变观念改革系统共创医院感染"零宽容"[J].中华内科杂志, 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. 张冀霞, 赵春江, 刘文云, 等.替加环素对鲍曼不动杆菌和肺炎克雷伯菌体外抗菌活性检测的影响因素和方法学评估[J].中华检验医学杂志, 2013, 36(7): 604-609．.
9. 杜小幸, 王海薄, 傅鹰, 等.不同药敏方法检测替加环素对鲍曼不动打菌敏感性的比较[J].中华检验医学杂志, 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. 闫少珍, 宋玥, 陈中举, 等. 4种方法检测替加环素对鲍曼不动杆菌和肠杆菌科细菌体外药敏结果分析[J].中华微生物学和免疫学杂志, 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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