Tigecycline therapy for carbapenem-resistant Klebsiella pneumoniae (CRKP) bacteriuria leads to tigecycline resistance

Clin Microbiol Infect. 2014 Dec;20(12):O1117-20. doi: 10.1111/1469-0691.12714. Epub 2014 Dec 12.

Abstract

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an increasing global threat. Here, we describe the prevalence and impact of tigecycline use in a cohort of patients with CRKP bacteriuria nested within a multicentre, prospective study. In the 21-month study period, 260 unique patients were included. Tigecycline was given to 80 (31%) patients. The use of tigecycline during the index hospitalization was significantly associated with the subsequent development of tigecycline resistance in the same patient (OR, 6.13; 95% CI, 1.15-48.65; p 0.03). In conclusion, the use of tigecycline with CRKP bacteriuria is common, and is associated with the subsequent development of tigecycline resistance.

Keywords: Carbapenem-resistant Enterobacteriaceae; multidrug resistance; urinary tract infection.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteriuria / drug therapy*
  • Bacteriuria / microbiology
  • Carbapenems / pharmacology
  • Cohort Studies
  • DNA, Bacterial / chemistry
  • DNA, Bacterial / genetics
  • Drug Resistance, Bacterial*
  • Female
  • Humans
  • Klebsiella Infections / drug therapy*
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae / drug effects*
  • Klebsiella pneumoniae / isolation & purification
  • Male
  • Middle Aged
  • Minocycline / analogs & derivatives*
  • Minocycline / pharmacology
  • Minocycline / therapeutic use
  • Molecular Sequence Data
  • Sequence Analysis, DNA
  • Tigecycline

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • DNA, Bacterial
  • Tigecycline
  • Minocycline

Associated data

  • GENBANK/AI072219