DOI: 10.5061/dryad.sqv9s4n6z
title: Tigecycline among clinically significant multidrug resistant pathogens

description: Purpose: Tigecycline, a glycylcycline antibiotic is a promising option for
 the treatment of single or multidrug-resistant pathogens. The aim of the
 study was to evaluate the in-vitro Tigecycline susceptibility of various
 pathogens from clinical samples received at tertiary care hospitals in
 South India.  Methods: The analysis of specimens from patients
 admitted was carried out in this retrospective cross-sectional study. The
 identification and antimicrobial susceptibility testing were performed by
 semi-automated Vitek 2 systems and Kirby Bauer method. The pattern of data
 analysis was done by descriptive statistics. Results: Among 2,574
 isolates, 812 isolates were gram-positive pathogens and 1762 isolates were
 gram-negative pathogens. Resistance to Tigecycline was more common among
 gram-negative pathogens (18.62%) in comparison to the gram-positive
 pathogens (0.49%). Among 740 Extended Spectrum Beta Lactamases (ESBL)
 producers such as Klebsiella species & E. coli, 629 isolates were
 susceptible, and 93 isolates were resistant to the tigecycline. All the
 Methicillin Resistant Staphylococcus aureus (MRSA) isolates were
 susceptible to tigecycline. Tigecycline was found to be highly effective
 in vitro for elimination of infections caused by both gram-positive and
 gram-negative pathogens. Conclusion: Multidrug-resistant (MDR) pathogens
 like Acinetobacter species and Klebsiella species are highly susceptible
 to Tigecycline, and it remains one of the key drugs in monotherapy
 & combination therapy. All MRSA were sensitive to tigeclycline.
 The use of combination therapy becomes crucial to prevent the development
 of Pan Drug resistance.
description: The comprehensive data which includes 2,574 clinically
 significant isolates were retrieved from Laboratory Information System and
 microbiology records from the KMC hospital. Study
 participants: The data of all samples received at Kasturba Medical College
 microbiology department were collected for a period of one year except for
 urine specimens as urinary concentration of tigecycline is poor.
 The positive cultures were identified and antibiotic
 susceptibility testing was done for tigecycline by Vitek 2 compact system
 and Kirby-Bauer Disk Diffusion method as per the manufacturer's
 & FDA-approved guidelines respectively and interpreted as
 sensitive & resistant. EUCAST criteria were used for
 interpretation of MIC which ranged from 0.06 to 64 and Disk diffusion with
 15 μg (Hi-Media). As per these criteria, MIC of tigecycline for
 Enterobacteriaciae &lt; 2ug/ml is sensitive, and &gt; 8ug/ml was
 considered resistant. By the Disk Diffusion method, the isolates with
 &gt;19mm & &lt; 14mm of zone diameter were considered as
 susceptible and resistant, respectively. All
 the <em>Staphylococcus</em> <em>aureus</em>
 isolates were screened for Methicillin resistance using the cefoxitin disk
 method or by Vitek 2 compact system and gram-negative Enterobacterales
 were screened for ESBL production using ceftazidime & ceftazidime
 clavulunic acid or Vitek 2 compact systems. Sample
 collection A convenient non-random sampling method was
 followed to collect data on specimens received at the microbiology
 laboratory of Kasturba Medical College, Mangalore.
 Statistical analysis All the data was
 entered into an Excel sheet and analyzed using IBM SPSS version 25. The
 continuous and categorical variables have been represented as mean ±
 standard deviation and frequency percentages respectively.
description: Microsoft Excel