Clinical and microbiological characteristics of tigecycline non-susceptible Klebsiella pneumoniaebacteremia in Taiwan

BMC Infectious Diseases

Research Article

Fu-Der Wang¹  Yi-Tsung Lin¹  Chang-Phone Fung¹  Yu-Jiun Chan²  Yung-Chieh Fu³ 

[1] Division of Infectious Disease, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, 112, Taipei, Taiwan;School of Medicine, National Yang-Ming University, Taipei, Taiwan;Division of Infectious Disease, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, 112, Taipei, Taiwan;School of Medicine, National Yang-Ming University, Taipei, Taiwan;Division of Microbiology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;Division of Microbiology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;

关键词: Antimicrobial resistance;    Bacteremia;    Clinical characteristics;    Klebsiella pneumoniae;    Tigecycline;   

DOI  :  10.1186/1471-2334-14-1

 received in 2013-10-17, accepted in 2013-12-09,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundResistance 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.MethodsAdult 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 β-lactamases, antimicrobial susceptibilities and pulsed-field gel electrophoresis (PFGE) results were determined for all isolates.ResultsOf 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 β-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.ConclusionsThe 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.

【 授权许可】

CC BY   
© Lin et al.; licensee BioMed Central Ltd. 2014