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In vitro Efficacy of Meropenem, Colistin and Tigecycline Against the Extended Spectrum Beta-Lactamase Producing Gram Negative Bacilli.

OBJECTIVE
To compare the in vitro efficacy of meropenem, colistin and tigecycline against extended spectrum Betalactamase producing Gram negative bacilli by minimal inhibitory concentration.


STUDY DESIGN
Cross-sectional descriptive study.


PLACE AND DURATION OF STUDY
Department of Microbiology, Army Medical College, National University of Sciences and Technology, Rawalpindi, from June to December 2010.


METHODOLOGY
Routine clinical specimens were subjected to standard microbiological procedures and the isolates were identified to species level. Extended spectrum β-lactamase producing Gram negative bacilli were detected by Jarlier disc synergy method and confirmed by ceftazidime and ceftazidime-clavulanate Etest. Minimum Inhibitory Concentration (MIC(90)) of meropenem, colistin and tigecycline was determined by Etest (AB BIOMERIUX) and the results were interpreted according to the manufacturer's instructions and Clinical and Laboratory Standards Institute guidelines and Food and Drug Authority recommendations. Results were analyzed by using Statistical Package for the Social Sciences version 20.


RESULTS
A total of 52 non-duplicate extended spectrum Beta-lactamase-producing Gram negative bacilli were included in the study. The MIC(90) of tigecycline (0.75 µg/ml) was lowest as compared to the meropenem (2 µg/ml) and colistin (3 µg/ml).


CONCLUSION
Tigecycline is superior in efficacy against the extended spectrum Beta-lactamase producing Gram negative bacilli as compared to colistin and meropenem.