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

ABSTRACT

Background: Tigecycline is used as a last line ofdefence against Multidrug Resistant (MDR) strains,and increasing rates of resistance are a growing concernglobally. Tigecycline resistance has been reported invarious pathogens including Acinetobacter spp.,Klebsiella spp., Enterobacter spp., E. faecalis, S.aureus, S. pneumoniae and Serratia marcescens. Aimand Objectives: To study Tigecycline susceptibilitypattern of isolates of Enterobacteriaceae andAcinetobacter spp. from Respiratory Tract Infections(RTI) in a tertiary care hospital. Material and Methods:A total of 7573 respiratory samples were received inMicrobiology Department of Govind Ballabh PantInstitute of Postgraduate Medical Education andst st Research (GIPMER) from 1 January 2018 to 31December 2018. The samples were processed as perstandard techniques. Identification and antimicrobialsusceptibility testing was done by VITEK-2 Compactautomated system and Kirby – Bauer Disc DiffusionMethod as per CLSI Guidelines. Results: Out of total7573 respiratory samples received in laboratory, 1017(13.42%) were culture positive for pathogens.Klebsiella pneumoniae 420(41.29%) waspredominantly isolated microorganism followed byPseudomonas aeruginosa 206(20.25%) andAcinetobacter spp. 193(18.97%). Most of Gramnegative organisms were resistant to commonly usedantibiotics. Carbapenem resistance was observed as67.25%. Conclusion: Overall Tigecycline resistanceamong Carbapenem Resistant Enterobacteriaceae(CRE) and Carbapenem Resistant Acinetobacter(CRA) was found to be 15.50% and 10.69%respectively. Although Tigecycline is a promisingantibiotic for the treatment of infections caused by drugresistant problematic pathogens, Tigecycline resistanceis most frequently observed in A. baumannii andEnterobacteriaceae, especially in MDR strains. Hence,we advocate judicious use of Tigecycline in MDRinfections and it should be kept as reserve.