Antimicrobial susceptibilities of urinary extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae to fosfomycin and nitrofurantoin in a teaching hospital in Taiwan

Abstract

Fosfomycin had the excellent activity against ESBL-EC but not ESBL-KP in this study. Based on the study findings, we suggest that fosfomycin can be a therapeutic option for UTIs with ESBL-EC. Nitrofuranoin was actively against ESBL-EC. Nitrofurantoin may be an alternative option for uncomplicated UTIs with ESBL-EC in Taiwan.

The Urinary System Infections caused by Extended-Spectrum-β-Lactamase-producing Escherichia coli and Klebsiella pneumoniae Strains

“…Carbapenems, such as imipenem and meropenem, are commonly used for the treatment of ESBL-positive and Gram-negative bacterial infections (1,3,18). Resistance rates of carbapenems have been reported between 0-11.1% (1,18). In our study, although no resistance was observed against imipenem and meropenem in E. coli and K. pneumoniae strains, the resistance rate of ertapenem was assessed as 1.9% and 3.8%, respectively.…”

“…Carbapenems are potent antibiotics which possess the broadest spectrum of activity. Carbapenems, such as imipenem and meropenem, are commonly used for the treatment of ESBL-positive and Gram-negative bacterial infections (1,3,18). Resistance rates of carbapenems have been reported between 0-11.1% (1,18).…”

“…Urinary system infections (USI) are mostly caused by Escherichia coli (E.coli) and Klebsiella pneumoniae (K. pneumoniae), which belonging to the family Enterobacteriaceae (1). In the treatment of USI, antibiotic resistance is a challenging problem.…”

In vitro Susceptibility Analysis of Escherichia coli Strains Isolated from Urinary Tract Infections to Fosfomycin, Nitrofurantoin and Ciprofloxacin

“…Liu ve ark. [15] Tayvan'da 2008 Temmuz ve 2009 Aralık ayını kapsayan bir çalışmada 134 GSBL (+) E. coli suşunun fosfomisine %95,5, nitrofurantoine %79,1, siprofloksasine ise %29,1 oranında duyarlı olduğunu bulmuşlardır. Ocak 2007 ile Aralık 2009 arasında İsviçre'de yapılan bir çalışmada, toplumdan kazanılmış ÜSE etkeni olan GSBL (+) E. coli suşlarında, nitrofurantoine %15, siprofloksasine %84,8, trimetoprimsülfometaksazole %75,9 oranında direnç görülmüştür.…”

An infectious disease and pharmacokinetic perspective on oral antibiotic treatment of uncomplicated urinary tract infections due to multidrug-resistant Gram-negative uropathogens: the importance of urinary antibiotic concentrations and urinary pH

“…In contrast, "high resistance potential" antibiotics often predispose to resistance even with limited use, e.g., ciprofloxacin [12,13,15,25] ( Table 4). Clearly, the three most useful, "low resistance potential" oral antibiotics ideal for the treatment of MDR GNB uropathogens are nitrofurantoin, doxycycline, and fosfomycin [15,25,[28][29][30][31][32][33][34][35][36]. These "low resistance potential" antibiotics are well tolerated and, properly used, have a good safety profile [15].…”