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Assessment of Tigecycline Response Level against Extended-Spectrum Beta-Lactamases Producing Pathogens Isolated from Surgical Site Infections

Author(s): Mohamed AH, Mohamed HA

Tigecycline is one of the sole antibiotics that can use in cases of extensive multidrug-resistant pathogens include Extended-Spectrum Beta-Lactamases (ESBL) producing pathogens. Tigecycline revealed significant efficacy and safety against Gram-positive, Gram-negative, and anaerobic microorganisms. The study aimed to reveal the antimicrobial sensitivity and resistance pattern of Tigecycline against ESBL pathogens isolated from surgical site infections. A total of 382 patients with confirmed surgical site infections included in this two-year study. MICs for Tigecycline had determined by using the broth microdilution method with a fresh Mueller-Hinton medium. The MIC breakpoints were as follows: ≤2 μg/g/mg/ml for susceptible; >2 to <8 μg/g/ml for intermediate; and ≥8 μg/g/ml for resistance. MIC50 and MIC90 represent the minimal concentration of antibiotic that inhibited the growth of 50% and 90% of the isolates. All ESBL producing pathogens in both gender and age groups and those admitted in the ICU had shown the highest sensitivity level against Tigecycline (100%) when compared to the other antimicrobial agents. Among the eight different pathogens obtained from culture results, E.coli was the common pathogen met in 49.2% of the samples. Among all medications, ampicillin showed the most resistant rate (100%) toward all pathogens, followed by ceftriaxone in 91.7%. About 64.6% of Fluoroquinolones, 72% against cephalosporins, and 8.2% toward Carbapenems were resistant against ESBL producing pathogens. Although ESBL cases are related to increased morbidity and mortality rates due to its nature of multidrug resistance pattern, Fortunately, Tigecycline gained the utmost sensitivity rate against all pathogens included Acinetobacter baumannii and Pseudomonas aeruginosa.

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