LAUSR

Tigecycline and comparators were tested by the reference broth microdilution method against 33 348 non-duplicate bacterial isolates collected prospectively in 2016 from medical centres in the Asia-Pacific (3443 isolates), Europe (13 530 isolates), Latin America (3327 isolates) and the USA (13 048 isolates). Among 7098 Staphylococcus aureus isolates tested, >99.9% were inhibited by ≤0.5 mg/L tigecycline (MIC50/90, 0.06/0.12 mg/L), including >99.9% of methicillin-resistant S. aureus and 100.0% of methicillin-susceptible S. aureus. Tigecycline was slightly more active against Enterococcus faecium (MIC50/90, 0.03/0.06 mg/L) compared with Enterococcus faecalis (MIC50/90, 0.06/0.12 mg/L) and its activity was not adversely affected by vancomycin resistance when tested against these organisms. Tigecycline potency was comparable for Streptococcus pneumoniae (MIC50/90, 0.03/0.06 mg/L), viridans group streptococci (MIC50/90, 0.03/0.06 mg/L) and β-haemolytic streptococci (MIC50/90, 0.06/0.06 mg/L) regardless of species and penicillin susceptibility. Tigecycline was active against Enterobacteriaceae (MIC50/90, 0.25/1 mg/L; 97.8% inhibited at ≤2 mg/L) but was slightly less active against Enterobacteriaceae isolates expressing resistant phenotypes: carbapenem-resistant Enterobacteriaceae (MIC50/90, 0.5/2 mg/L; 98.0% susceptible); multidrug-resistant (MIC50/90, 0.5/2 mg/L; 93.1% susceptible); and extensively drug-resistant (MIC50/90, 0.5/4 mg/L; 87.8% susceptible). Tigecycline inhibited 74.4% of 888 Acinetobacter baumannii isolates at ≤2 mg/L (MIC50/90, 2/4 mg/L) and demonstrated good in vitro activity against Stenotrophomonas maltophilia (MIC50/90, 1/2 mg/L; 90.6% inhibited at ≤2 mg/L) Tigecycline was active against Haemophilus influenzae (MIC50/90, 0.12/0.25 mg/L) regardless of β-lactamase status. Tigecycline represents an important treatment option for resistant Gram-negative and Gram-positive bacterial infections.