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Summary Background As part of the Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) we report antimicrobial resistance among Gram-positive and Gram-negative isolates collected globally from integumentary sources between 2010 and 2014. Methods Minimum inhibitory concentrations and antimicrobial resistance were determined according to Clinical and Laboratory Standards Institute guidelines (US Food and Drug Administration breakpoints against tigecycline). The Cochran–Armitage trend test was used to identify statistically significant changes in resistance. Results Global rates of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Acinetobacter baumannii were 38% and 43%, respectively. No S. aureus isolates were resistant to linezolid or vancomycin; all isolates were susceptible to tigecycline. Two percent of Enterococcus faecalis and 28% of Enterococcus faecium were vancomycin-resistant. Extended-spectrum β-lactamase (ESBL) producers accounted for 22% of Klebsiella pneumoniae and 16% of Escherichia coli . Resistance to minocycline among E. faecalis , E. faecium , K. pneumoniae , and E. coli decreased significantly ( p < 0.0001). There were significant increases ( p < 0.0001) in A. baumannii resistance to cefepime, ceftazidime, ceftriaxone, levofloxacin, meropenem, and piperacillin–tazobactam. Conclusions Among isolates from integumentary sources, rates of MRSA and ESBL-producing Enterobacteriaceae are stabilizing. Carbapenems and tigecycline have retained their in vitro activity against Gram-positive and Gram-negative organisms. Few agents were active against A. baumannii ; its increasing resistance is cause for concern. [ABSTRACT FROM AUTHOR]

Summary: From 2005 to 2009, at Detroit Medical Center, the prevalence of Providencia stuartii increased from 0.52 to 0.91/1000 patient-days (p <0.001). The use of colistin also increased (p <0.001) during the study period. The increase in the prevalence of P. stuartii was associated with an increased use of colistin (p <0.001). Facilities that frequently use colistin and tigecycline should closely monitor the prevalence of P. stuartii along with other Proteeae, since these organisms are intrinsically resistant to colistin and tigecycline. [ABSTRACT FROM AUTHOR]