The Resistance of Uropathogenic Bacteria to Fosfomycin

Abstract

Urinary tract infection is among bacterial infections that provide antibiotic treatment. The overly systematic use of a single class of antibiotic induces a selection pressure leading to bacterial resistance. The purpose of this study is to evaluate the level of resistance and to follow the evolution of the sensitivity of uropathogenic bacteria to fosfomycin to allow a better antibiotherapy of urinary infections. This is a prospective 3-year study of all positive cytobacterioligical urine exam from inpatients or consultants who have arrived at the microbiology laboratory at the Avicenne Military Hospital in Marrakech. Of the 12,116 cytobacterioligical urine exam performed, 1788 met the criteria for urinary tract infection. These urinary infections mainly concerned patients followed externally (1471). The sex ratio between men and women is 1.07. Of the isolated uropathogenic bacteria, E. coli is the predominant strain (51% isolates). Uropathogenic bacteria were sensitive to fosfomycin in more than 90% of cases, and this sensitivity was favorable during the study period. On the other hand, a high frequency of resistance has been recorded for betalactamines, in particular amoxicillin and amoxicillin-clavulanic acid. Fosfomycin has excellent activity on bacteria of urinary tract infections so its single dose prescription would be effective in uncomplicated urinary tract infections.