Tigecycline activity tested against carbapenem-resistant Enterobacteriaceae from 18 European nations: results from the SENTRY surveillance program (2010-2013)

We evaluated the in vitro activity of tigecycline and selected comparator agents tested against carbapenem-resistant Enterobacteriaceae (CRE) isolated from European medical centers. A total of 14,286 clinically significant nonduplicate Enterobacteriaceae isolates were collected from 18 European countries in 2010-2013. Susceptibility testing was performed by CLSI broth microdilution method, and isolates with a meropenem or imipenem MIC at ≥4 μg/mL were categorized as CRE. Selected CRE strains were screened for acquired carbapenemases by multiplex polymerase chain reaction and sequencing. Overall, 2.0% (280/14,286) of Enterobacteriaceae strains were CRE. The highest CRE occurrence was observed in Poland (17.3%; 70/405), followed by Italy (7.5%, 130/1,743), Greece (7.4%; 45/605), and Romania (5.0%; 8/157). The most common CRE species were Klebsiella pneumoniae (242; 86.4%) and Enterobacter cloacae (22; 7.9%), and the most common carbapenemases were KPC-2/3 (85.4%) and VIM-type (12.5%). Only tigecycline (88.6% susceptible) and colistin (73.9%) exhibited good in vitro activity (>70.0%) against CRE strains.