<i>In-Vitro</i>Susceptibility of Quinolone-Resistant Clinical Isolates of<i>Escherichia coli</i>to Fosfomycin Trometamol

Ungheri, D.; Albini, E.; Belluco, G

doi:10.1179/joc.2002.14.3.237

Cited by 28 publications

(18 citation statements)

References 7 publications

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“…1). These results are similar to those described in previous reports of non-ESBLproducing isolates (2,8,14), confirming that fosfomycin retains its activity against ESBL-producing isolates, and cross-resistance with other classes of antimicrobial agents is not a problem at present.…”

supporting

confidence: 81%

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In Vitro Activity of Fosfomycin against Extended-Spectrum-β-Lactamase- Producing Escherichia coli and Klebsiella pneumoniae : Comparison of Susceptibility Testing Procedures

Cueto

López

Hernández

et al. 2006

Antimicrob Agents Chemother

103

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The agar dilution, broth microdilution, and disk diffusion methods were compared to determine the in vitro susceptibility of 428 extended-spectrum-␤-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae to fosfomycin. Fosfomycin showed very high activity against all ESBL-producing strains. Excellent agreement between the three susceptibility methods was found for E. coli, whereas marked discrepancies were observed for K. pneumoniae.Fosfomycin tromethamine is a stable salt of fosfomycin which is licensed for the single-dose treatment of acute uncomplicated urinary tract infections (UTIs) caused by susceptible organisms (8,12). After many years of fosfomycin use, both in Spain and worldwide, fosfomycin continues to be active against the most common uropathogens, and there is a very low incidence of resistant strains in Escherichia coli (about 2%) (2,12,14).Isolation of extended-spectrum-␤-lactamase (ESBL)-producing E. coli and Klebsiella pneumoniae strains is increasing in Spain, and a high proportion of these isolates are recovered from outpatients with uncomplicated UTIs (4, 7, 11). It is common to find that the same plasmid coding for ESBL also contains genes conferring resistance to several groups of antimicrobial agents, such as aminoglycosides and cotrimoxazole (7, 10). The concurrence of quinolone resistance, particularly in ESBL-producing K. pneumoniae, is frequent (6, 10, 13), there being few alternatives for the appropriate oral treatment of uncomplicated UTIs caused by ESBL-producing microorganisms.The present study was designed to assess the in vitro activity of fosfomycin by three different methods against 428 ESBLproducing strains, made up of 290 (68%) E. coli and 138 (32%) K. pneumoniae isolates.The strains were collected in two Spanish studies: the first, developed in 2000, included 40 hospitals representing different regions of Spain, and the second was carried out in Seville, Spain, at the University Hospital of Virgen Macarena (UHVM), using strains recovered between 1995 and 2001 (7, 11). In both studies ESBL production was determined by broth microdilution according to CLSI guidelines (5).The strains collected from the multicenter study included 170 E. coli and 70 K. pneumoniae strains, while those obtained from the UHVM included 120 E. coli and 68 K. pneumoniae strains. One-hundred thirty-two out of 290 (45.5%) E. coli and 16 out of 138 (11.6%) K. pneumoniae strains were isolated from outpatients with community-acquired infections, and among these isolates found in the community, 66 (22.7%) E. coli and 9 (6.5%) K. pneumoniae strains were isolated from urine samples of women with uncomplicated UTIs.The MICs of fosfomycin (Zambon, Milan, Italy) were determined by the agar dilution and broth microdilution methods in cation adjusted Mueller-Hinton medium, supplemented with 25 mg/liter of G-6-P (glucose-6-phosphate; Sigma Chemical Co.). A twofold dilution across a range of 0.25 to 512 mg of fosfomycin per liter was used. The inocula were prepared to achieve 1 ϫ 10 4 CFU per spot (ag...

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supporting

confidence: 81%

“…After many years of fosfomycin use, both in Spain and worldwide, fosfomycin continues to be active against the most common uropathogens, and there is a very low incidence of resistant strains in Escherichia coli (about 2%) (2,12,14).…”

mentioning

confidence: 99%

In Vitro Activity of Fosfomycin against Extended-Spectrum-β-Lactamase- Producing Escherichia coli and Klebsiella pneumoniae : Comparison of Susceptibility Testing Procedures

Cueto

López

Hernández

et al. 2006

Antimicrob Agents Chemother

103

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“…In a similar study Goldstein [20] showed that the activity of fosfomycin against uropathogens was superior to ciprofl oxacin, norfl oxacin and cotrimoxazole. Moreover, it has been demonstrated that fosfomycin tromethamine is active in the urine against common uropathogens, including organisms resistant to other antibiotics, such as quinolone-resistant strains of E. coli [21,22] .…”

Section: Discussionmentioning

confidence: 99%

Fosfomycin Tromethamine in Uncomplicated Urinary Tract Infections: A Clinical Study

et al. 2005

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The aim of our study was to verify if the empiric therapy with a single dose of 3 g fosfomycin tromethamine in patients with uncomplicated urinary tract infections (UTIs) was able to clinically resolveand to microbiologically eradicate the infection. A total of 387 out of the 400 patients (274 cases with acute and 113 cases with recurrent uncomplicated UTIs) were enrolled in the clinical study. Clinical and microbiological assessments were performed before and at 8–10 days after the administration. At follow-up high clinical recovery (88.9%) and bacteriological (94.9%) eradication rates were achieved. Gastrointestinal side effects were found in only 4.3% of patients. In conclusion, a single-dose administration regimen of fosfomycin tromethamine should be encouraged as a first choice of drug therapy for uncomplicated UTIs.

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“…A clinical success rate up to 90% has been reported by FMT use in ESBL-positive E. coli-related infections [20]. ESBL was detected in 7 E. coli strains that were sensitive to FMT in the present study.…”

Section: Discussionmentioning

confidence: 54%

A randomized comparative study of single-dose fosfomycin and 5-day ciprofloxacin in female patients with uncomplicated lower urinary tract infections

Ceran

Mert

Kocdogan

et al. 2010

Journal of Infection and Chemotherapy

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In-VitroSusceptibility of Quinolone-Resistant Clinical Isolates ofEscherichia colito Fosfomycin Trometamol

Cited by 28 publications

References 7 publications

In Vitro Activity of Fosfomycin against Extended-Spectrum-β-Lactamase- Producing Escherichia coli and Klebsiella pneumoniae : Comparison of Susceptibility Testing Procedures

In Vitro Activity of Fosfomycin against Extended-Spectrum-β-Lactamase- Producing Escherichia coli and Klebsiella pneumoniae : Comparison of Susceptibility Testing Procedures

Fosfomycin Tromethamine in Uncomplicated Urinary Tract Infections: A Clinical Study

A randomized comparative study of single-dose fosfomycin and 5-day ciprofloxacin in female patients with uncomplicated lower urinary tract infections

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