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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Infectious Diseases 1/2014

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

Zeitschrift:
BMC Infectious Diseases > Ausgabe 1/2014
Autoren:
Yi-Tsung Lin, Fu-Der Wang, Yu-Jiun Chan, Yung-Chieh Fu, Chang-Phone Fung
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2334-14-1) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

YTL conceived the study, and participated in its design and coordination. YTL, FDW, YJC, and YCF reviewed and collected the data. YTL analyzed and interpreted the data. YTL drafted the manuscript. FDW and CPF reviewed the manuscript. All authors approved the final manuscript.

Abstract

Background

Resistance 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.

Methods

Adult 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.

Results

Of 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.

Conclusions

The 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.
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