Invitro Activity of Tigecycline against Multidrug-Resistant Enterobacteriaceae from Blood Stream Infection in a Tertiary Care Hospital of Nepal

Background: Multidrug resistant (MDR) enterobacteriaceae like extended spectrum beta lactamase (ESBL) and metallo-beta lactamase (MBL) are being encountered as the causative agents of blood stream infection. To overcome this, accurate diagnosis of MDR pattern with appropriate antibiotics is required. Tigecycline is a broad spectrum antibiotic which exhibit strong activity against MDR enterobacteriaceae. This study is aimed to find out resistance pattern like ESBL and MBL with invitro activity of tigecycline against enterobacteriaceae. Methods: A descriptive cross-sectional study was conducted in the Department of Microbiology, B.P. Koirala Institute of Health Sciences, from 1st September 2014 to 31st August 2015. Confirmation for ESBL was done as recommended by Clinical and Laboratory Standard Institute (CLSI) and MBL production was detected by double disk synergy test. Antibiotic sensitivity test against tigecycline was done by Kirby-Bauer disk diffusion method. Results: 192 (1.70%) enterobacteriaceae were isolated throughout the study. Among them, 94 (49%) were ESBL, 51 (26.5%) were carbapenemase and 22 (11.5%) were MBL producers. A total of 64 (33.4%) isolates were found to be MDR. None of the isolates was resistant against tigecycline. Conclusion: Tigecycline is found to have excellent invitro activity against MDR enterobacteriaceae from BSI.