Background: Fosfomycin is an old antibiotic that is being reconsidered for the treatment of lower urinary tract, due to the global increasing resistance of several bacteria to numerous-antimicrobials. Objectives: To evaluate the activity of fosfomycin and to detect fosfomycin resistant genes (FosA3 and FosC2) in extended-spectrum-beta-lactamase producing Enterobacteriaceae isolates from Menoufia University Hospitals. Methodology: The study included 155 samples collected from patients from different departments and ICUs at Menoufia University Hospitals, detected the ESBLproducing,by combined confirmatory method, fosfomycin resistance was assessed by disk diffusion and the minimal inhibitory concentration (MIC) by E-test method and fosfomycin resistance genes (FosA3 and FosC2) were detected by the conventional PCR. Results: Among the 48 ESBL-producing Enterobacteriaceae isolates analyzed in this study, 21 isolates had fosfomycin resistant genes (FosA3 and FosC2). Conclusion: Fosfomycin showed good antimicrobial activity against multidrug-resistant ESBLpositive Enterobacteriaceae. Resistance genes (FosA3 and FosC2) were detected in some strains, however, other resistance mechanisms to fosfomycin may exist.
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