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Background  The Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) was designed to monitor  in vitro  antimicrobial susceptibility to tigecycline and comparator agents. We present susceptibility data on Gram-negative organisms collected between 2005 and 2011 from nine United States census regions.    Methods  T.E.S.T. was conducted using standardized CLSI methodologies or FDA-approved breakpoints.    Results  Tigecycline was highly active (MIC 90  ≤ 2 mg/L) against Enterobacteriaceae irrespective of species or region of collection (N = 25011). The isolates were also highly susceptible to the carbapenems when all regional data are combined, except for ESBL-producing  Klebsiella pneumoniae  (MIC 90  16 mg/L) and  Acinetobacter baumannii  (MIC 90  ≥ 32 mg/L). In addition, 883 (30%) of 2900  A. baumannii  isolates were classified as multidrug-resistant (MDR): these MDR organisms were most susceptible to tigecycline (MIC 90  2 mg/L) and minocycline (MIC 90  8 mg/L) when all regional data are considered together. Susceptibility patterns also varied widely among the regions    Conclusions  The findings highlight the importance of monitoring antimicrobial susceptibility patterns and implementing effective methods to curb increased resistance and also confirm that additional studies to determine the efficacy of tigecycline  in vivo , especially for treating infections with MDR organisms, are warranted.

annals of clinical microbiology and antimicrobials

Antimicrobial susceptibility among gram-negative isolates collected in the USA between 2005 and 2011 as part of the Tigecycline Evaluation and Surveillance Trial (T.E.S.T.)