Antimicrobial Susceptibility of Fosfomycin in Bacterial Isolates From Urinary Tract Infection : A Study From Tertiary Healthcare Center in Himachal Pradesh

Abstract

BACKGROUND: Urinary tract infections (UTIs) are common with an annual global incidence of at least 250 million cases; and Escherichia coli is the most common pathogen. Many antibiotics once used to treat UTI are now ineffective due to the development of antimicrobial resistance. Fosfomycin, discovered in late 1960s, has rekindled clinical interests because of reported susceptibilities of current pathogens to the agent. This study was done with the objective to determine in vitro fosfomycin susceptibility of common uropathogens and determining the antimicrobial susceptibility pattern of these organisms. MATERIAL AND METHOD: Retrospective study was conducted in the Department of Microbiology for a duration of 2 years from October 2019 to September 2021. Urine samples were received and culture was done on MacConkey agar and AST was performed on signicant bacteriuria ≥105 CFU /ml with fosfomycin as per CLSI guidelines. Total of 9442 urine samples were collected duri RESULT: ng the duration of 2 years. Out of these 1657(17.5%) showed signicant growth. Male to female ratio was 1:1.9 in our study. Majority of the bacteria isolated were uropathogenic E.coli 960(57.9%) followed by Klebsiella spp 185(11.1%). Susceptibility to fosfomycin was seen majorly in all enterobacterales with 96.7% sensitivity to E.coli and 100% sensitivity towards Staphylococcus aureus and Enterococcus spp. In CONCLUSION: conclusion, our study indicates that fosfomycin is active in vitro against a considerable percentage of urinary isolates, which simultaneously exhibit high rates of antimicrobial drug resistance to the conventionally used antimicrobial agents.