Emergence of increased Pseudomonas aeruginosa infections during tigecycline use

23rd European Congress of Clinical Microbiology an Infectious Diseases, Germany, 1 - 04 April 2013, no.2105, pp.171

Background: Tigecycline demonstrates a potent broad-spectrum in vitro antibacterial activity against clinically

important gram-positive and gram-negative aerobic bacteria and anaerobes, but with the exception of

intrinsically resistant Pseudomonas aeruginosa (PA). Aim of this study is to evaluate if the treatment with

tigecycline is a risk factor for PA infection. Materials and methods: We performed a retrospective and

observational study during 2008-2010. Patients with PA infection were compared patients with nosocomial

infection other than PA. Patients were analyzed according to receive tigecycline before PA infection and also

the following data: sex, age, underlying diseases, infections, invasive procedures. Statistical analysis was

performed using Chi-square test and multiple logistic regression models. Results: A total of 1167 patients with

any hospital infections included to the study. Of these infections 493 (42%) were ventilator associated

pneumonia (VAP), 187(16%) were urinary tract infections (UTI),145 (12,4%) were bacteremia, 143 (12,2%)

were surgical site infections, 59(5%) were skin &soft tissue infections, 47 (4 %) were other nosocomial

infections. 278 (23,8 %) of them were with PA infection compared to 889 (76,2 %) patient without PA

infections. One hundred twelve (34 %) of patients received tigecycline before PA infection documented found

to be significantly more frequent rather than nosocomial infections (p< 0,01). Mean age of patients with PA

infections was 52 (4-86). PA infections were significantly more common against young patients. Underlying

diseases (malignancies, burn, diabetes mellitus, and steroid use, and immunsupression, cardiac, hepatic and

renal failure) were similar between to groups. Tracheostomy, thoracic drainage catheter and external ventricular

drain were also found significant risk factors for PA infections. Conclusion: PA is a frequent cause of serious

infections among hospitalized patients associated with considerable morbidity and mortality. Tigecycline

represents a therapeutic option in treating multidrug-resistant Gram-negative