Clinical and microbiological analysis of risk factors for breakthrough bloodstream infection during Tigecycline Therapy
Abstract Background Tigecycline is widely used to treat a variety of bacterial infections despite concerns regarding increased mortality in severe infections. Previous case reports have documented breakthrough bloodstream infections (BSI) during tigecycline therapy. This study aimed to investigate t...
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Nature Portfolio
2025-02-01
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| Online Access: | https://doi.org/10.1038/s41598-025-88048-7 |
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| author | Sol Jin So Yun Lim Yun Woo Lee Heungsup Sung Mi-Na Kim Seongman Bae Jiwon Jung Min Jae Kim Sung-Han Kim Sang-Oh Lee Sang-Ho Choi Yang Soo Kim Eun Hee Song Yong Pil Chong |
| author_facet | Sol Jin So Yun Lim Yun Woo Lee Heungsup Sung Mi-Na Kim Seongman Bae Jiwon Jung Min Jae Kim Sung-Han Kim Sang-Oh Lee Sang-Ho Choi Yang Soo Kim Eun Hee Song Yong Pil Chong |
| author_sort | Sol Jin |
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| description | Abstract Background Tigecycline is widely used to treat a variety of bacterial infections despite concerns regarding increased mortality in severe infections. Previous case reports have documented breakthrough bloodstream infections (BSI) during tigecycline therapy. This study aimed to investigate the incidence of, and risk factors for, breakthrough BSI during tigecycline monotherapy. Methods A retrospective matched case–control study was conducted in a 2700-bed tertiary referral center, involving patients who received tigecycline monotherapy. Patients with breakthrough BSI (1:1) were matched with controls without breakthrough BSI based on age, sex, and date of tigecycline therapy. Results Of 4505 patients treated with tigecycline, 115 (2.6%, 95% confidence interval 2.1 to 3.1%) developed breakthrough BSI. The most frequently identified pathogen in breakthrough BSI was Klebsiella pneumoniae (22.8%), followed by Candida species (17.1%), Pseudomonas aeruginosa (16.3%), and Acinetobacter baumannii (14.6%). Of the K. pneumoniae and A. baumannii isolates for which tigecycline susceptibility results were available, 50% and 23%, respectively, were tigecycline-resistant (MIC > 2 mg/L). Intraabdominal (33.9%), catheter-related (30.4%), and hepatobiliary (19.1%) infections were the main sources of breakthrough BSI. In multivariable analysis, independent risk factors for breakthrough BSI during tigecycline therapy were liver cirrhosis (adjusted odds ratio [aOR], 3.09), indwelling catheter (aOR, 3.42), previous Candida colonization (aOR, 14.95), and previous multi-drug resistant bacteria colonization (aOR, 10.30). Conclusion In cases where there is a high suspicion of breakthrough BSI during tigecycline therapy, meticulous management and prudent selection of empirical antibiotics are crucial due to the diverse range of causative microorganisms involved. |
| format | Article |
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| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-02-01 |
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| spelling | doaj-art-184d0e9eddc546b595b54f45de627c2a2025-02-09T12:30:30ZengNature PortfolioScientific Reports2045-23222025-02-011511910.1038/s41598-025-88048-7Clinical and microbiological analysis of risk factors for breakthrough bloodstream infection during Tigecycline TherapySol Jin0So Yun Lim1Yun Woo Lee2Heungsup Sung3Mi-Na Kim4Seongman Bae5Jiwon Jung6Min Jae Kim7Sung-Han Kim8Sang-Oh Lee9Sang-Ho Choi10Yang Soo Kim11Eun Hee Song12Yong Pil Chong13Department of Infectious Diseases, Kosin University Gospel HospitalDepartment of Infectious Diseases, Asan Medical Center, University of Ulsan College of MedicineDepartment of Infectious Diseases, Asan Medical Center, University of Ulsan College of MedicineDepartment of Laboratory Medicine, Asan Medical Center, University of Ulsan College of MedicineDepartment of Laboratory Medicine, Asan Medical Center, University of Ulsan College of MedicineDepartment of Infectious Diseases, Asan Medical Center, University of Ulsan College of MedicineDepartment of Infectious Diseases, Asan Medical Center, University of Ulsan College of MedicineDepartment of Infectious Diseases, Asan Medical Center, University of Ulsan College of MedicineDepartment of Infectious Diseases, Asan Medical Center, University of Ulsan College of MedicineDepartment of Infectious Diseases, Asan Medical Center, University of Ulsan College of MedicineDepartment of Infectious Diseases, Asan Medical Center, University of Ulsan College of MedicineDepartment of Infectious Diseases, Asan Medical Center, University of Ulsan College of MedicineDepartments of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of MedicineDepartment of Infectious Diseases, Asan Medical Center, University of Ulsan College of MedicineAbstract Background Tigecycline is widely used to treat a variety of bacterial infections despite concerns regarding increased mortality in severe infections. Previous case reports have documented breakthrough bloodstream infections (BSI) during tigecycline therapy. This study aimed to investigate the incidence of, and risk factors for, breakthrough BSI during tigecycline monotherapy. Methods A retrospective matched case–control study was conducted in a 2700-bed tertiary referral center, involving patients who received tigecycline monotherapy. Patients with breakthrough BSI (1:1) were matched with controls without breakthrough BSI based on age, sex, and date of tigecycline therapy. Results Of 4505 patients treated with tigecycline, 115 (2.6%, 95% confidence interval 2.1 to 3.1%) developed breakthrough BSI. The most frequently identified pathogen in breakthrough BSI was Klebsiella pneumoniae (22.8%), followed by Candida species (17.1%), Pseudomonas aeruginosa (16.3%), and Acinetobacter baumannii (14.6%). Of the K. pneumoniae and A. baumannii isolates for which tigecycline susceptibility results were available, 50% and 23%, respectively, were tigecycline-resistant (MIC > 2 mg/L). Intraabdominal (33.9%), catheter-related (30.4%), and hepatobiliary (19.1%) infections were the main sources of breakthrough BSI. In multivariable analysis, independent risk factors for breakthrough BSI during tigecycline therapy were liver cirrhosis (adjusted odds ratio [aOR], 3.09), indwelling catheter (aOR, 3.42), previous Candida colonization (aOR, 14.95), and previous multi-drug resistant bacteria colonization (aOR, 10.30). Conclusion In cases where there is a high suspicion of breakthrough BSI during tigecycline therapy, meticulous management and prudent selection of empirical antibiotics are crucial due to the diverse range of causative microorganisms involved.https://doi.org/10.1038/s41598-025-88048-7TigecyclineBreakthrough bacteremiaRisk factorsBreakthrough infection |
| spellingShingle | Sol Jin So Yun Lim Yun Woo Lee Heungsup Sung Mi-Na Kim Seongman Bae Jiwon Jung Min Jae Kim Sung-Han Kim Sang-Oh Lee Sang-Ho Choi Yang Soo Kim Eun Hee Song Yong Pil Chong Clinical and microbiological analysis of risk factors for breakthrough bloodstream infection during Tigecycline Therapy Scientific Reports Tigecycline Breakthrough bacteremia Risk factors Breakthrough infection |
| title | Clinical and microbiological analysis of risk factors for breakthrough bloodstream infection during Tigecycline Therapy |
| title_full | Clinical and microbiological analysis of risk factors for breakthrough bloodstream infection during Tigecycline Therapy |
| title_fullStr | Clinical and microbiological analysis of risk factors for breakthrough bloodstream infection during Tigecycline Therapy |
| title_full_unstemmed | Clinical and microbiological analysis of risk factors for breakthrough bloodstream infection during Tigecycline Therapy |
| title_short | Clinical and microbiological analysis of risk factors for breakthrough bloodstream infection during Tigecycline Therapy |
| title_sort | clinical and microbiological analysis of risk factors for breakthrough bloodstream infection during tigecycline therapy |
| topic | Tigecycline Breakthrough bacteremia Risk factors Breakthrough infection |
| url | https://doi.org/10.1038/s41598-025-88048-7 |
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