1. In vitro activity of fosfomycin trometamol and other oral antibiotics against multidrug-resistant uropathogens
- Author
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Tiziana Zingali, Giulia La Rosa, Gaetano Maugeri, Carla Caio, Maria Lina Mezzatesta, Andrea Novelli, and Stefania Stefani
- Subjects
0301 basic medicine ,Microbiology (medical) ,Klebsiella pneumoniae ,030106 microbiology ,Microbial Sensitivity Tests ,Fosfomycin ,Microbiology ,03 medical and health sciences ,Enterobacteriaceae ,Clavulanic acid ,medicine ,Humans ,Pharmacology (medical) ,Staphylococcus saprophyticus ,biology ,business.industry ,Broth microdilution ,Bacterial Infections ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,Amoxicillin ,bacterial infections and mycoses ,biology.organism_classification ,Proteus mirabilis ,Anti-Bacterial Agents ,Ciprofloxacin ,Infectious Diseases ,Urinary Tract Infections ,business ,ESBL ,Fosfomycin trometamol ,Urinary tract infections ,Uropathogens ,medicine.drug - Abstract
© 2017 Elsevier B.V. and International Society of Chemotherapy Clinical midstream and urinary catheter isolates (n = 106) of extended-spectrum β-lactamase (ESBL)-positive Escherichia coli, Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae, Proteus mirabilis and meticillin-resistant Staphylococcus saprophyticus were tested against fosfomycin using the agar dilution method, the broth microdilution method and the gradient test described by the Clinical and Laboratory Standards Institute. Nitrofurantoin, co-trimoxazole, amoxicillin/clavulanic acid, cefuroxime, levofloxacin and ciprofloxacin were tested using the gradient test alone. Breakpoints from the European Committee on Antimicrobial Susceptibility Testing 2015 guidelines were used. Fosfomycin inhibited all of the ESBL-positive E. coli, P. mirabilis and meticillin-resistant S. saprophyticus strains isolated from urine, as well as 82% of KPC-producing K. pneumoniae isolates. Substantial agreement for fosfomycin activity was found for the three test methods, particularly for Enterobacteriaceae. This study confirmed that fosfomycin has good in vitro activity against more common multidrug-resistant uropathogens. Fosfomycin could be a reliable empirical therapeutic option for uncomplicated urinary tract infections caused by these organisms, and a valid option for sparing parenteral antibiotics, such as carbapenems.
- Published
- 2017