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Background  A high level of antibiotic consumption in France means antimicrobial resistance requires rigorous monitoring. The Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) is a global surveillance study that monitors the in vitro activities of tigecycline and a panel of marketed antimicrobials against clinically important Gram-positive and Gram-negative isolates.    Methods  Annually clinically relevant strains were prospectively included in the survey through a national network of hospital-based laboratories. MICs were determined locally by broth microdilution using CLSI guidelines. Antimicrobial susceptibility was assessed using European Committee on Antimicrobial Susceptibility Testing breakpoints.    Results  Thirty-three centres in France collected 26,486 isolates between 2004 and 2016.  Enterococcus  species were highly susceptible (≥94.4%) to linezolid, tigecycline and vancomycin.  Staphylococcus aureus , including methicillin-resistant  S. aureus  (MRSA), were susceptible (≥99.9%) to tigecycline, vancomycin and linezolid. Between 2004 and 2016, 27.7% of  S. aureus  isolates were MRSA, decreasing from 28.0% in 2013 to 23.5% in 2016. Susceptibility of  Streptococcus pneumoniae  isolates was 100% to vancomycin, and > 99.0% to levofloxacin, linezolid and meropenem; 3.0% were penicillin-resistant  S. pneumoniae  (100% susceptibility to vancomycin and linezolid).  Escherichia coli  isolates were highly susceptible (> 98.0%) to meropenem, tigecycline and amikacin. The rate of extended-spectrum β-lactamase (ESBL) positive  E. coli  increased from 2004 (3.0%), but was stable from 2012 (23.1%) to 2016 (19.8%). Susceptibility of  Klebsiella pneumoniae  isolates was 99.4% to meropenem and 96.5% to amikacin. The proportion of ESBL-positive  K. pneumoniae  isolates increased from 2004 (7.5%) to 2012 (33.3%) and was highest in 2016 (43.6%).  A. baumannii  was susceptible to meropenem (81.0%) and amikacin (74.9%); none of the 6.2% of isolates identified as multidrug-resistant (MDR) was susceptible to any agents with breakpoints.  P. aeruginosa  isolates were most susceptible to amikacin (88.5%), and MDR rates were 13.6% in 2013 to 4.0% in 2016; susceptibility of MDR isolates was no higher than 31.4% to amikacin.    Conclusions  Rates of MRSA decreased slowly, while rates of ESBL-positive  E. coli  and  K. pneumoniae  increased from 2004 to 2016. Susceptibility of Gram-positive isolates to vancomycin, tigecycline, meropenem and linezolid was well conserved, as was susceptibility of Gram-negative isolates to tigecycline and meropenem. The spread of MDR non-fermentative isolates must be carefully monitored.

antimicrobial resistance and infection control

The Tigecycline Evaluation and Surveillance Trial; assessment of the activity of tigecycline and other selected antibiotics against Gram-positive and Gram-negative pathogens from France collected between 2004 and 2016