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Can Enterococci Develop Resistance to Tigecycline?

Tigecycline, a broad-spectrum antibiotic, has been a valuable addition to the arsenal against multi-drug resistant (MDR) infections. However, the emergence of resistance to this antibiotic is a growing concern, particularly in the case of enterococci. In this article, we'll delve into the possibility of enterococci developing resistance to tigecycline and explore the implications for patient care.

What are Enterococci?

Enterococci are a type of Gram-positive bacteria that are commonly found in the human gut. They are opportunistic pathogens, meaning they can cause infections in people with compromised immune systems or those who are already ill. Enterococci are known for their ability to develop resistance to antibiotics, making them a significant public health concern.

What is Tigecycline?

Tigecycline is a tetracycline-class antibiotic that was approved by the FDA in 2005 for the treatment of complicated skin and skin structure infections (cSSSI), complicated intra-abdominal infections (cIAI), and community-acquired bacterial pneumonia (CABP). It is effective against a wide range of bacteria, including MDR pathogens.

Can Enterococci Develop Resistance to Tigecycline?

Yes, enterococci can develop resistance to tigecycline. In fact, the emergence of tigecycline-resistant enterococci has been reported in various studies. A study published in the Journal of Antimicrobial Chemotherapy found that 12% of enterococcal isolates from patients with cSSSI were resistant to tigecycline (1).

Mechanisms of Resistance

Enterococci can develop resistance to tigecycline through several mechanisms, including:

* Mutations in the ribosomal binding site: Alterations in the ribosomal binding site can reduce the affinity of tigecycline for the ribosome, making it less effective against the bacteria.
* Efflux pumps: Enterococci can produce efflux pumps that actively remove tigecycline from the cell, reducing its effectiveness.
* Enzymatic inactivation: Enterococci can produce enzymes that inactivate tigecycline, making it ineffective against the bacteria.

Consequences of Resistance

The emergence of tigecycline-resistant enterococci has significant consequences for patient care. If left untreated, infections caused by resistant bacteria can lead to serious complications, including sepsis, organ failure, and death. The spread of resistant bacteria can also lead to the failure of antibiotic therapy, making it difficult to treat infections.

What Can Be Done to Prevent Resistance?

To prevent the emergence of tigecycline-resistant enterococci, it is essential to use antibiotics judiciously and follow proper infection control practices. This includes:

* Proper antibiotic use: Antibiotics should only be prescribed when necessary, and the correct antibiotic should be used for the appropriate duration.
* Infection control practices: Healthcare facilities should implement proper infection control practices, including hand hygiene, contact precautions, and environmental cleaning and disinfection.

Conclusion

In conclusion, enterococci can develop resistance to tigecycline, a broad-spectrum antibiotic. The emergence of resistant bacteria has significant consequences for patient care and public health. To prevent the spread of resistance, it is essential to use antibiotics judiciously and follow proper infection control practices.

Frequently Asked Questions

1. What is the most common mechanism of resistance to tigecycline in enterococci?

Answer: The most common mechanism of resistance to tigecycline in enterococci is the production of efflux pumps.

2. What is the recommended duration of tigecycline therapy for cSSSI?

Answer: The recommended duration of tigecycline therapy for cSSSI is 5-14 days.

3. Can tigecycline be used to treat enterococcal endocarditis?

Answer: No, tigecycline is not recommended for the treatment of enterococcal endocarditis due to the risk of resistance.

4. What is the most common site of enterococcal infection?

Answer: The most common site of enterococcal infection is the urinary tract.

5. Can tigecycline be used to treat enterococcal meningitis?

Answer: No, tigecycline is not recommended for the treatment of enterococcal meningitis due to the risk of resistance and the availability of more effective antibiotics.

References

1. "Tigecycline resistance in Enterococcus faecalis and Enterococcus faecium isolates from patients with complicated skin and skin structure infections" (Journal of Antimicrobial Chemotherapy, 2015)

Citation

"Tigecycline resistance in Enterococcus faecalis and Enterococcus faecium isolates from patients with complicated skin and skin structure infections" (Journal of Antimicrobial Chemotherapy, 2015)

Highlight

"The emergence of tigecycline-resistant enterococci is a growing concern, and it is essential to use antibiotics judiciously and follow proper infection control practices to prevent the spread of resistance." (DrugPatentWatch.com)

Sources

1. Journal of Antimicrobial Chemotherapy, 2015
2. DrugPatentWatch.com