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. 2017 Jun;6(2):233-243.
doi: 10.1007/s40121-017-0150-5. Epub 2017 Mar 11.

Fosfomycin and Comparator Activity Against Select Enterobacteriaceae, Pseudomonas, and Enterococcus Urinary Tract Infection Isolates from the United States in 2012

Tiffany R Keepers  1 , Marcela Gomez  1 , Chris Celeri  1 , Kevin M Krause  1 , Donald Biek  1 , Ian Critchley  2   3
Affiliations

Fosfomycin and Comparator Activity Against Select Enterobacteriaceae, Pseudomonas, and Enterococcus Urinary Tract Infection Isolates from the United States in 2012

Tiffany R Keepers et al. Infect Dis Ther. 2017 Jun.

Abstract

Introduction: Fosfomycin is a broad-spectrum cell wall active agent that inhibits the MurA enzyme involved in peptidoglycan synthesis and is FDA-approved for treatment of uncomplicated urinary tract infections (UTIs) caused by Escherichia coli and Enterococcus faecalis in women. Data regarding the susceptibility of recent UTI isolates to fosfomycin are limited.

Methods: This study compared the fosfomycin susceptibility of 658 US UTI isolates with susceptibility to ciprofloxacin, levofloxacin, nitrofurantoin, and trimethoprim/sulfamethoxazole (SXT). Isolates included E. coli (n = 257), Klebsiella spp. (n = 156), Enterobacter spp. (n = 79), Pseudomonas aeruginosa (n = 60), E. faecalis (n = 54), and Proteus spp. (n = 52). Extended-spectrum β-lactamase (ESBL)-producing E. coli, Klebsiella spp., and Proteus mirabilis, ceftazidime-nonsusceptible P. aeruginosa and Enterobacter spp., and vancomycin-nonsusceptible E. faecalis were included.

Results: Overall, the minimum concentration inhibiting 50% of isolates (MIC50) and 90% of isolates (MIC90) for fosfomycin were 4 and 64 µg/mL, respectively. Of the 257 E. coli isolates, 99.6% were susceptible to fosfomycin. Ciprofloxacin, levofloxacin, SXT, and nitrofurantoin susceptibility rates were 65.4%, 65.8%, 59.9%, and 90.3%, respectively. The fosfomycin-susceptibility rate for E. faecalis (94.4%) was comparable with the nitrofurantoin-susceptibility rate (98.1%). Among the 144 ESBL-producing isolates, the fosfomycin MIC50 and MIC90 values were 2 and 32 µg/mL, respectively. Fosfomycin MIC50 and MIC90 values were 16 and 128 µg/mL for the 38 ceftazidime-nonsusceptible Enterobacter isolates and 64 and 128 µg/mL for the 15 ceftazidime-nonsusceptible P. aeruginosa isolates, respectively.

Conclusion: These results demonstrate that fosfomycin has in vitro activity against many US UTI isolates, including drug-resistant isolates, and may provide another therapeutic option for treatment of UTIs caused by antibiotic-resistant pathogens.

Keywords: Antimicrobial; Fosfomycin; Urinary tract infection.

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References

    1. Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52:e103–e120. doi: 10.1093/cid/ciq257. - DOI - PubMed
    1. Sader HS, Flamm RK, Jones RN. Frequency of occurrence and antimicrobial susceptibility of Gram-negative bacteremia isolates in patients with urinary tract infection: results from United States and European hospitals (2009–2011) J Chemother. 2014;26:133–138. doi: 10.1179/1973947813Y.0000000121. - DOI - PubMed
    1. Bonkat G, Muller G, Braissant O, et al. Increasing prevalence of ciprofloxacin resistance in extended-spectrum-beta-lactamase-producing Escherichia coli urinary isolates. World J Urol. 2013;31:1427–1432. doi: 10.1007/s00345-013-1031-5. - DOI - PubMed
    1. Sanchez GV, Babiker A, Master RN, et al. Antibiotic resistance among urinary isolates from female outpatients in the United States in 2003 and 2012. Antimicrob Agents Chemother. 2016;60:2680–2683. doi: 10.1128/AAC.02897-15. - DOI - PMC - PubMed
    1. Tchesnokova V, Billig M, Chattopadhyay S, et al. Predictive diagnostics for Escherichia coli infections based on the clonal association of antimicrobial resistance and clinical outcome. J Clin Microbiol. 2013;51:2991–2999. doi: 10.1128/JCM.00984-13. - DOI - PMC - PubMed

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