The emergence of tet(X) variants highlight challenges for the global genomic surveillance of tigecycline resistance

Abstract

Tigecycline is one of the last-line antimicrobials against infections caused by multidrug-resistant bacteria. Recent articles published in The Lancet Microbe have highlighted the spread of tigecycline resistance mediated by the RND efflux pump gene cluster tmexCD-toprJ, in clinically important pathogens.1–3 Conversely, plasmid-borne tet(X) genes encoding tigecycline-inactivating enzymes have been quietly emerging.4 Despite more than 20 tet(X) variants having already been described, their identification by large-scale genomic data is restricted.

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