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CORRESPONDENCE
Year : 2009  |  Volume : 27  |  Issue : 4  |  Page : 373-374
 

Comparative in vitro antimicrobial activity of tigecycline against clinical isolates of vancomycin-resistant enterococcus


1 Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
2 Department of Microbiology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey

Date of Submission02-Nov-2008
Date of Acceptance17-Feb-2009
Date of Web Publication4-Sep-2009

Correspondence Address:
M Yemisen
Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul University, Istanbul
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.55455

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How to cite this article:
Yemisen M, Demirel A, Mete B, Kaygusuz A, Mert A, Tabak F, Ozturk R. Comparative in vitro antimicrobial activity of tigecycline against clinical isolates of vancomycin-resistant enterococcus. Indian J Med Microbiol 2009;27:373-4

How to cite this URL:
Yemisen M, Demirel A, Mete B, Kaygusuz A, Mert A, Tabak F, Ozturk R. Comparative in vitro antimicrobial activity of tigecycline against clinical isolates of vancomycin-resistant enterococcus. Indian J Med Microbiol [serial online] 2009 [cited 2020 Jul 8];27:373-4. Available from: http://www.ijmm.org/text.asp?2009/27/4/373/55455


Dear Editor,

In last four decades, tetracyclines have been widely used due to their broad-spectrum of antimicrobial activity against Gram-positive and Gram-negative bacteria. However, indications for the use of tetracyclines have been limited due to the emergence of resistant strains. Tigecycline, [1] former GAR-936, is the first representative of a new class of antimicrobial agents known as glycylcyclines. Tigecycline may be an alternative for the treatment of Vancomycin-resistant Enterococcus (VRE), one of the most important and emerging causes of human nosocomial infections. In this study, we evaluate the In vitro activity of tigecycline in comparison to other antimicrobial agents against VRE isolates obtained from the patients followed in our university hospital.

About 22 Enterococcus faecalis and six Enterococcus faecium isolates were obtained from clinical materials (19 urine, nine blood) of hospitalised patients. Patients with VRE blood stream infection were followed in the intensive care unit, had central venous catheter and severe underlying diseases. Isolates were identified to genus level by Gram staining, L-pyrrolindonyl-b-naphthylamide reaction, catalase reaction, bile esculin test, salt tolerance and streptococcal grouping. Identification to species level was performed using the API Rapid ID 32 Strep system (BioMe´rieux, Marcy l'Etoile, France). Antibiotic susceptibility testing was performed by disk diffusion, as recommended by the Clinical Laboratory Standard Institute [2] (CLSI, formerly NCCLS). For isolates not fully susceptible to vancomycin, the MIC of vancomycin was determined by Etest (AB Biodisk, Solna, Sweden), using the high-inoculum method on Mueller-Hinton agar. All 28 isolates, obtained from cultures were stored in brain-heart infusion broth at -70ºC.

In this study, antimicrobial susceptibility testing was performed against eight antimicrobial agents by using broth microdilution method, as described by the CLSI. Minimal inhibitory concentration (MIC) was defined as the lowest concentration of antimicrobial agent producing no visible growth of microorganism at 37ºC after overnight incubation. MIC 50 and MIC 90 was determined by the concentrations of antimicrobial agent at which 50% and 90% of microorganism are inhibited, respectively. We decided to determine both MIC 50 and MIC 90 values to show the potency of anibiotics. The following quality control strains were concurrently tested by using E. faecalis ATCC 29212 and E. faecium ATCC 6057.

Results of the In vitro susceptibility testing are presented in [Table 1]. The antimicrobial activity of tigecycline was compared to those selected antimicrobial agents. Tigecycline was highly active against VRE. MIC 50 and MIC 90 values were 0.06 and 0.12 µg/mL, respectively and same for E. faecalis and E. faecium isolates. Only one islolate showed a MIC value of 0.5 µg/mL over 0.25 µg/mL and the tigecycline MIC range of the isolates was between 0.03 and 0.5 µg/mL. The vast majority of strains showed high MIC values against other antibiotics. Linezolid was another antibiotic with low MIC 50 and MIC 90 values, which was 4 µg/mL for both.

In conclusion, VRE is an emerging problem and antibiotic sources are limited. Our study agrees with previous In vitro studies [3],[4] and shows that tigecycline has high In vitro activity against VRE. These results suggest that further prospective clinical studies must be performed and tigecycline may have an important role in the treatment of severely ill patients infected with VRE.


 ~ Acknowledgments Top


This study was funded by Wyeth Pharmaceuticals.

 
 ~ References Top

1.Sum PE, Petersen P. Synthesis and structure-activity relationship of novel glycylcycline derivatives leading to the discovery of GAR-936. Bioorg Med Chem Lett 1999;9:1459-62.  Back to cited text no. 1    
2.Clinical and Laboratory Standards Institute. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow Aerobically. 7th ed. Approved Standard M07-A7. Wayne, PA, USA: CLSI; 2006.  Back to cited text no. 2    
3.Garrison MW, Nuemiller JJ. In vitro activity of tigecycline against quinolone-resistant Streptococcus pneumoniae , methicillin-resistant Staphylococcus aureus and vancomycin resistant enterococci. Int J Antimicrob Agents 2007;29:191-6.   Back to cited text no. 3    
4.Cercenado E, Cercenado S, Gómez JA, Bouza E. In vitro activity of tigecycline (GAR-936), a novel glycylcycline, against vancomycin resistant enterococci and staphylococci with diminished susceptibility to glycopeptides. J Antimicrob Chemother 2003;52:138-9.  Back to cited text no. 4    



 
 
    Tables

  [Table 1]

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1 Prevalence of Multidrug Resistant Enterococci in a Tertiary Care Hospital in India: A Growing Threat
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[Pubmed] | [DOI]
2 Evaluation of tigecycline activity in clinical isolates among Indian medical centers
Manoharan, A., Chatterjee, S., Madhan, S., Mathai, D.
Indian Journal of Pathology and Microbiology. 2010; 53(4): 734-737
[Pubmed]



 

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