Antimicrobial susceptibilities of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in health care-associated urinary tract infection: focus on susceptibility to fosfomycin

Cho, Yang Hyun; Jung, Seung Il; Chung, Hyun-Chul; Yu, Ho Song; Hwang, Eu Chang; Kim, Sun-Ouck; Kang, Taek Won; Kwon, Dong Deuk; Park, Kwangsung

doi:10.1007/s11255-015-1018-9

Cited by 56 publications

(41 citation statements)

References 31 publications

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“…Our results are similar, to some extent, to those reported by Jones et al (Jones et al, 2002), Iroha et al(Iroha et al, 2015), Cho et al(Cho et al, 2015), Chen et al(Chen et al, 2015) who found that carbapenems (biapenem, meropenem and imipenem) exhibited high antimicrobial activities against Gram-negative bacteria especially E. coli and Klebsiella pneumoniae. Also Turner examined the activity of meropenem against a total of 5208 isolates of Enterobacteriaceae; the susceptibility rate for meropenem was (99.4%).…”

Section: Resultssupporting

confidence: 92%

Comparative Study of Different Methods of Detection of β-lactamase Production in Gram Negative Bacterial Isolates and Studying Induction of Resistance to Cefipime

El-Nakeeb¹,

Omar²,

Abozahra³

et al. 2016

Int.J.Curr.Microbiol.App.Sci

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Section: Resultssupporting

confidence: 92%

Comparative Study of Different Methods of Detection of β-lactamase Production in Gram Negative Bacterial Isolates and Studying Induction of Resistance to Cefipime

El-Nakeeb¹,

Omar²,

Abozahra³

et al. 2016

Int.J.Curr.Microbiol.App.Sci

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“…Fosfomycin presented high levels of activity against E. coli. However, this drug was less active against Klebsiella spp., which displayed a higher MIC distribution (21)(22)(23). Falagas et al reported that the fosfomycin MIC distribution can be quite variable and can also be influenced by several factors, including bacterial species (24).…”

Section: Discussionmentioning

confidence: 99%

Pharmacodynamic Evaluation of Fosfomycin against Escherichia coli and Klebsiella spp. from Urinary Tract Infections and the Influence of pH on Fosfomycin Activities

Fedrigo

Mazucheli

Albiero

et al. 2017

Antimicrob Agents Chemother

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Fosfomycin is widely used for the treatment of uncomplicated urinary tract infection (UTI), and it has recently been recommended that fosfomycin be used to treat infections caused by multidrug-resistant (MDR) Gram-negative bacilli. Whether urine acidification can improve bacterial susceptibility to fosfomycin oral dosing regimens has not been analyzed. The MIC of fosfomycin for 245 Gramnegative bacterial isolates, consisting of 158 Escherichia coli isolates and 87 Klebsiella isolates which were collected from patients with urinary tract infections, were determined at pH 6.0 and 7.0 using the agar dilution method. Monte Carlo simulation of the urinary fosfomycin area under the concentration-time curve (AUC) after a single oral dose of 3,000 mg fosfomycin and the MIC distribution were used to determine the probability of target attainment (PTA). Fosfomycin was effective against E. coli (MIC 90 Յ 16 g/ml) but not against Klebsiella spp. (MIC 90 Ͼ 512 g/ml). Acidification of the environment increased the susceptibility of 71% of the bacterial isolates and resulted in a statistically significant decrease in bacterial survival. The use of a regimen consisting of a single oral dose of fosfomycin against an E. coli isolate with an MIC of Յ64 mg/liter was able to achieve a PTA of Ն90% for a target pharmacodynamic index (AUC/MIC) of 23 in urine; PTA was not achieved when the MIC was higher than 64 mg/liter. The cumulative fractions of the bacterial responses (CFR) were 99% and 55% against E. coli and Klebsiella spp., respectively, based on simulated drug exposure in urine with an acidic pH of 6.0. A decrease of the pH from 7.0 to 6.0 improved the PTA and CFR of the target pharmacodynamic index in both E. coli and Klebsiella isolates.KEYWORDS Enterobacteriaceae, fosfomycin, Monte Carlo simulation, acidic pH, pharmacodynamics, urinary tract infection U rinary tract infections (UTIs) are the most common infections worldwide, and members of the family Enterobacteriaceae are the main pathogens responsible for UTIs (1). The rise in the rate of antibiotic resistance over the last several years has resulted in limited treatment options currently available for the treatment of infections caused by multidrug-resistant (MDR) bacteria. Fosfomycin is an old antibiotic agent frequently used to treat uncomplicated UTIs and has been reevaluated as a potential option for the treatment of infections caused by MDR Gram-negative bacteria (2). The dosage currently approved for the treatment of an uncomplicated UTI is a single

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“…Cumulative susceptibility of fosfomycin against ESBL positive Enterobacteriaceae is reported as 87.7% according to CLSI criteria (24). However, lower susceptibility rates (<50%) was showed in some studies, and in a study this agent was shown to be active against only 50% of Klebsiella (22,25).…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of fosfomycin combinational therapy for sepsis caused by carbapenem-resistant Klebsiella pneumoniae

Liao

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to compare the efficacy and safety of fosfomycin combinational therapy with other antibiotics for the treatment of infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). This retrospective cohort study examined 104 cases of sepsis caused by CRKP occurring between January 2012 and November 2014 in Shanghai Tenth People's Hospital. Three categories of patient outcome were assessed: Survival/mortality, duration of intensive care unit stays and duration of medical ventilation. Univariate ordinal analyses were adopted to evaluate the correlations between outcome and treatment. A total of 104 patients with physician-diagnosed CRKP were involved in the study. The overall mortality rate was 25.0%. The majority of the infections (84; 80.8%) were hospital acquired. Critical infections received more than one active antibiotic as therapy. Patients treated with fosfomycin combinational therapy were less likely to fail therapy (OR: 4.71, 95% CI: 1.03-21.65, P=0.034) and tended to have a shorter duration of mechanical ventilation. Gender (OR: 4.35, 95% CI: 1.08-3.60, P= 0.037), history of chronic obstructive pulmonary disease (OR: 9.35, 95% CI: 0.06-0.19, P=0.007) and peripheral catheter use (OR: 3.00, 95% CI: 0.07-0.19, P=0.002) are risk factors for clinical outcome. Therefore, the use of fosfomycin combinational therapy for treatment of infection due to CRKP appears to be associated with improved survival rate.

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Antimicrobial susceptibilities of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in health care-associated urinary tract infection: focus on susceptibility to fosfomycin

Cited by 56 publications

References 31 publications

Comparative Study of Different Methods of Detection of β-lactamase Production in Gram Negative Bacterial Isolates and Studying Induction of Resistance to Cefipime

Comparative Study of Different Methods of Detection of β-lactamase Production in Gram Negative Bacterial Isolates and Studying Induction of Resistance to Cefipime

Pharmacodynamic Evaluation of Fosfomycin against Escherichia coli and Klebsiella spp. from Urinary Tract Infections and the Influence of pH on Fosfomycin Activities

Retrospective analysis of fosfomycin combinational therapy for sepsis caused by carbapenem-resistant Klebsiella pneumoniae

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