Susceptibility of uropathogenic multidrug-resistant Escherichia coli to Fosfomycin

Abstract

CONTEXT: Escherichia coli is one of the most important causes of urinary tract infections (UTIs). Increased antibiotic resistance may limit the therapeutic options for the treatment of E. coli infections. Fosfomycin an orally dispensed antibiotic has shown promising in vitro activity against multidrug-resistant (MDR) urinary E. coli pathogen; however, current resistance data from India are scarce. AIM: The aim of this study is to evaluate the in vitro Fosfomycin activity against uropathogenic MDR E. coli. MATERIALS AND METHODS: A total of 150 previously confirmed MDR E. coli urinary isolates were included in this study. Susceptibility testing and result interpretation of isolates to Fosfomycin was performed by the disc diffusion method as per the Clinical and Laboratory Standards Institute M100-S25 recommendations. RESULTS: Fosfomycin appears to exhibit excellent in vitro activity against the MDR E. coli urinary isolates. The susceptibility for Nitrofurantoin was fair, whereas for Ampicillin, Ofloxacin, Norfloxacin, Cefazoline and Trimethoprim/Sulphamethoxazole was found poor. CONCLUSION: In view of the high in vitro susceptibility to Fosfomycin in this population and the lack of cross-resistance between Fosfomycin and other agents, Fosfomycin may be considered a useful reserve drug in the treatment of uncomplicated UTIs caused by MDR E. coli.