Importation of Fosfomycin Resistance<i>fosA3</i>Gene to Europe

Mendes, Ana Constança; Rodrigues, Carla; Pires, João; Amorim, José; Ramos, Maria da Conceição Pereira; Novais, Ângela; Peixe, Luı́sa

doi:10.3201/eid2202.151301

Cited by 24 publications

(18 citation statements)

References 10 publications

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“…So, further studies should be performed in order to detect possible genetic targets, such as fosA3 gene, that encode for a specific enzyme and which have recently resulted in a high resistance level to fosfomycin among European KPC-producers. 10 In conclusion, this study reports a significant emergence of fosfomycin resistance among KPC-2-Kp isolates in a relatively short period after the introduction of this antibiotic as an effective agent to treat KPC infections. Strict control practices are urgently required in order to avoid the resistance rate increase, regardless of the mechanism by which it occurs.…”

Section: Driven By Prior Use In Critically Ill Patientsmentioning

confidence: 60%

Menacing Emergence of Fosfomycin Resistance Among Klebsiella pneumoniae Carbapenemase–2-Producing K. pneumoniae Driven by Prior Use in Critically Ill Patients

Perez

2016

Infect. Control Hosp. Epidemiol.

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Section: Driven By Prior Use In Critically Ill Patientsmentioning

confidence: 60%

Menacing Emergence of Fosfomycin Resistance Among Klebsiella pneumoniae Carbapenemase–2-Producing K. pneumoniae Driven by Prior Use in Critically Ill Patients

Perez

2016

Infect. Control Hosp. Epidemiol.

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“…UTIs would be found to harbor fosA3-mediating plasmids in high frequency in China 145) . Moreover, FosA3 producers have also been spreading outside of Asia [146][147][148][149][150] . Therefore, further prevalence of fosA3 among the ESBL-producing E. coli showing resistance to fluoroquinolones, which are mostly E. coli ST131 subclones, H30 151,152) and H30Rx 153) clades, should be more carefully monitored in days to come within the community, especially in UTI patients 154) .…”

Section: Tenri Japanmentioning

confidence: 99%

ESBL-producing <i>Escherichia coli</i> and Its Rapid Rise among Healthy People

et al. 2017

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Since around the 2000s, Escherichia coli (E. coli) resistant to both oxyimino-cephalosporins and fluoroquinolones has remarkably increased worldwide in clinical settings. The kind of E. coli is also identified in patients suffering from communityonset infectious diseases such as urinary tract infections. Moreover, recoveries of multi-drug resistant E. coli from the feces of healthy people have been increasingly documented in recent years, although the actual state remains uncertain. These E. coli isolates usually produce extended-spectrum β-lactamase (ESBL), as well as acquisition of amino acid substitutions in the quinolone-resistance determining regions (QRDRs) of GyrA and/or ParC, together with plasmid-mediated quinolone resistance determinants such as Qnr, AAC(6')-Ib-cr, and QepA. The actual state of ESBL-producing E. coli in hospitalized patients has been carefully investigated in many countries, while that in healthy people still remains uncertain, although high fecal carriage rates of ESBL producers in healthy people have been reported especially in Asian and South American countries. The issues regarding the ESBL producers have become very complicated and chaotic due to rapid increase of both ESBL variants and plasmids mediating ESBL genes, together with the emergence of various "epidemic strains" or "international clones" of E. coli and Klebsiella pneumoniae harboring transferable-plasmids carrying multiple antimicrobial resistance genes. Thus, the current state of ESBL producers outside hospital settings was overviewed together with the relation among those recovered from livestock, foods, pets, environments and wildlife from the viewpoint of molecular epidemiology. This mini review may contribute to better understanding about ESBL producers among people who are not familiar with the antimicrobial resistance (AMR) threatening rising globally.

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“…The current resistance rate of E. coli to fosfomycin is estimated to be lower than 5%, and lower than 10% among extended spectrum β-lactamase (ESBL) producers worldwide [11][12][13]. In South Korea, the fosfomycin resistance rate has been reported to be up to 3% in clinical E. coli isolates, and up to 7% among ESBL producers [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Fosfomycin Resistance in Escherichia coli Isolates from South Korea and in vitro Activity of Fosfomycin Alone and in Combination with Other Antibiotics

Seok

Choi

et al. 2020

Antibiotics

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We investigated fosfomycin susceptibility in Escherichia coli clinical isolates from South Korea, including community-onset, hospital-onset, and long-term care facility (LTCF)-onset isolates. The resistance mechanisms and genotypes of fosfomycin-resistant isolates were also identified. Finally, the in vitro efficacy of combinations of fosfomycin with other antibiotics were examined in susceptible or extended spectrum β-lactamase (ESBL)-producing E. coli isolates. The fosfomycin resistance rate was 6.7% and was significantly higher in LTCF-onset isolates than community-onset and hospital-onset isolates. Twenty-one sequence types (STs) were identified among 19 fosfomycin-resistant E. coli isolates, showing diverse genotypes. fosA3 was found in only two isolates, and diverse genetic variations were identified in three genes associated with fosfomycin resistance, namely, GlpT, UhpT, and MurA. Some fosfomycin-resistant E. coli isolates carried no mutations. In vitro time-kill assays showed that fosfomycin alone did not exhibit an excellent killing activity, compared with ciprofloxacin in susceptible isolates and with ertapenem in ESBL producers. However, combining fosfomycin with cefixime or piperacillin-tazobactam eradicated susceptible or ESBL-producing isolates, respectively, even with 0.5× minimum inhibitory concentrations. Overall, we found a relatively high fosfomycin resistance rate in E. coli isolates from South Korea. Based on their genotypes and resistance mechanisms, most of the fosfomycin-resistant E. coli isolates might occur independently. Antibiotic combinations with fosfomycin could be a suitable therapeutic option for infections caused by E. coli isolates.

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Importation of Fosfomycin ResistancefosA3Gene to Europe

Cited by 24 publications

References 10 publications

Menacing Emergence of Fosfomycin Resistance Among Klebsiella pneumoniae Carbapenemase–2-Producing K. pneumoniae Driven by Prior Use in Critically Ill Patients

Menacing Emergence of Fosfomycin Resistance Among Klebsiella pneumoniae Carbapenemase–2-Producing K. pneumoniae Driven by Prior Use in Critically Ill Patients

ESBL-producing <i>Escherichia coli</i> and Its Rapid Rise among Healthy People

Fosfomycin Resistance in Escherichia coli Isolates from South Korea and in vitro Activity of Fosfomycin Alone and in Combination with Other Antibiotics

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