Back to Journals » Infection and Drug Resistance » Volume 12

Risk factors with the development of infection with tigecycline- and carbapenem-resistant Enterobacter cloacae

Authors Jiang Y, Jia X, Xia Y

Received 11 October 2018

Accepted for publication 31 January 2019

Published 20 March 2019 Volume 2019:12 Pages 667—674

DOI https://doi.org/10.2147/IDR.S189941

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony


Yuansu Jiang,* Xiaojiong Jia,* Yun Xia

Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China

*These authors contributed equally to this work

Background: Tigecycline is regarded as a last resort treatment for carbapenem-resistant Enterobacter cloacae (CREC) infections, and increasing numbers of tigecycline- and carbapenem-resistant E. cloacae (TCREC) isolates have been reported in recent years. However, risk factors and clinical impacts of these isolates are poorly characterized.
Patients and methods: We conducted a retrospective case-case-control study of hospitalized patients with TCREC infection during the period 2012–2016 in Chongqing, China. Case patients with TCREC and those with CREC were compared to a control group with no E. cloacae infection. Multivariate logistic regression models were used to identify independent risk factors for acquiring TCREC and CREC.
Results: A total of 36 TCREC cases, 36 CREC cases, and 100 controls were enrolled in our study. Multivariable analysis indicated that nasal catheter (OR: 8.9; 95% CI: 1.1–75.2), exposure to penicillin (OR: 95.9; 95% CI: 8.9–1038.3), aminoglycosides (OR: 42.1; 95% CI: 2.1–830.6), and fluoroquinolones (OR: 18.6; 95% CI: 1.9–185.6) were independent predictors for acquiring TCREC. In addition, venous catheterization (OR: 12.2; 95% CI: 2.5–58.5), penicillin (OR: 30.8; 95% CI: 7.9–120.0), and broad-spectrum cephalosporin (OR: 5.0; 95% CI: 1.5–17.3) were independently associated with CREC acquisition.
Conclusion: Reasonable antibiotic stewardship programs and surveillance are necessary to control the tigecycline resistance among high-risk patients.

Keywords: carbapenem resistance, tigecycline, Enterobacter cloacae, risk factor

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]