Is there a rise in resistance rates to fosfomycin and other commonly used antibiotics in Escherichia coli-mediated urinary tract infections? A perspective for 2004 – 2011

Pullukçu, Hüsnü; Aydemir, Sabire; Taşbakan, Meltem; Sıpahi, Oğuz Reşat; Hall, Fatma Feriha Çilli; Tünger, Alper

doi:10.3906/sag-1210-75

Cited by 10 publications

(11 citation statements)

References 42 publications

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“…As a direct result, carbapenem has been increasingly used in the empirical treatment of complicated UTI, which has led to an increase in bacterial resistance, an imbalance of commensal flora and increased risk of fungal infection 15. Fortunately, unlike resistance against cephalosporins and fluoroquinolones of common UTI pathogens, the resistance rate to fosfomycin has not increased in the recent years 16. Previous single-centre studies have achieved good results with fosfomycin in the treatment of UTIs caused by ESBL-producing bacteria 17.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of three-dose fosfomycin tromethamine in the treatment of patients with urinary tract infections: an uncontrolled, open-label, multicentre study

et al. 2013

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ObjectiveTo evaluate the clinical and microbiological efficacy and safety of three doses of 3 g fosfomycin tromethamine administered orally to treat lower urinary tract infections.Design and participantsThis prospective, uncontrolled, open-label study was conducted in 12 medical centres in China, between January and December 2011. According to the diagnosis criteria of Chinese Guidelines on Urological Infections, patients (18–70 years) with acute uncomplicated cystitis, recurrent lower urinary tract infection or complicated lower urinary tract infection received three doses of 3 g fosfomycin tromethamine orally, at days 1, 3 and 5.Primary and secondary outcome measuresEfficacy endpoints (clinical efficacy, microbiological efficacy and overall efficacy) were evaluated on day 15. Clinical symptoms, physical signs, urinalysis, liver and kidney function, patient records and evaluation of adverse events (AEs) and serious AEs up to day 15 were evaluated for analysis of safety.Results361 patients were included in the full analysis set, 356 in the safety analysis set and 335 in the per-protocol set (PPS). In the PPS, the clinical efficacy rates at day 15 for acute uncomplicated cystitis, recurrent lower urinary tract infection and complicated lower urinary tract infection were 94.71% (179/189), 77.22% (61/79) and 62.69% (42/67), respectively. The microbiological efficacy rates (day 15) were 97.65% (83/85), 94.44% (34/36) and 83.87% (26/31), respectively. The overall efficacy rates (day 15) were 95.29% (81/85), 77.78% (28/36) and 64.52% (20/31), respectively. 20/356 (5.6%) patients reported drug-related AEs, the most common being diarrhoea. No serious drug-related AEs were reported.ConclusionsThis fosfomycin tromethamine dosing regimen showed clinical and microbiological efficacy with some AEs and good tolerability in patients with acute uncomplicated cystitis, recurrent lower urinary tract infection and complicated lower urinary tract infection.

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Section: Discussionmentioning

confidence: 99%

Evaluation of three-dose fosfomycin tromethamine in the treatment of patients with urinary tract infections: an uncontrolled, open-label, multicentre study

et al. 2013

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“…Pullukçu ve ark. [13] ve 2011 yılları için karşılaştırıldığında ise sırasıyla siprofloksasin direnci %39, %36,4 fosfomisin direnci ise %0 ve %0,9 olarak bulunmuştur. Köken ve ark.…”

Section: Discussionunclassified

“…Pullukçu ve ark. [13] toplamda 6439 E. coli suşunda fosfomisin direncini %1,9 olarak tespit etmişlerdir. Bizim çalışmamızda 366 suşta fosfomisin direnci %0,3'tür.…”

Section: Discussionunclassified

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

Soydan¹,

Karadağ²,

Çalışkan³

et al. 2015

mjima

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Giriş: Escherichia coli komplike olmayan alt üriner sistem enfeksiyonlarından (ÜSE) en sık izole edilen mikroorganizmadır. E. coli kökenlerinde yüksek siprofloksasin direnci ve artmış genişlemiş spektrumlu beta-laktamaz (GSBL) üretimi, alternatif tedavi arayışlarını gündeme getirmiştir. Gereç ve Yöntem:Çalışmamıza Derince Eğitim ve Araştırma Hastanesi'nde, farklı departmanlardan laboratuvarımıza gönderilen, ÜSE tanısı almış hastaların idrar örneklerinden izole edilen 366 E. coli kökeni dahil edildi. Bulgular:Çalışmaya dahil edilen 366 suşun 90'ının (%24,6) GSBL pozitif, 276'sının (%75,4) ise GSBL negatif olduğu görüldü. GSBL (+) ve GSBL (-) E. coli suşlarında duyarlılık oranları sırasıyla, fosfomisine %100 ve %99,7, nitrofurantoine %80 ve %90,6, siprofloksasine %40 ve %80,8 olarak bulundu. Sonuç:Çalışmaya alınan E. coli suşlarında siprofloksasin direncinin yüksek, fosfomisin ve nitrofurantoin direncinin düşük olduğu tespit edilmiştir.Bu nedenle hastanemize başvuran hastalarda E. coli oluşturulan non-komplike ÜSE'lerin tedavisinde fosfomisin ve nitrofurantoinin ampirik tedavi amacıyla kullanılabileceği kanaatine varılmıştır.Anahtar Kelimeler: İdrar yolu enfeksiyonu, genişlemiş spektrumlu beta-laktamaz, Escherichia coli, fosfomisin, nitrofurantoin, siprofloksasin ÖzIntroduction: Escherichia coli is the most commonly isolated microorganism from uncomplicated lower urinary tract infections (UTI). The occurrence of high ciprofloxacin resistance and production of extended spectrum beta-lactamase (ESBL) in E. coli isolates have led the researchers to investigate new treatment approaches. Materials and Methods: A total of 366 E. coli strains isolated from urine samples of patients with the diagnosis of UTI, who were referred to our laboratory from different departments at our hospital, were included in this study. Results: Ninety (24.6%) isolates were found to be ESBL-positive and 276 (75.4%) were ESBL-negative. The rates of susceptibility to fosfomycin, nitrofurantoin and ciprofloxacin in ESBL-positive and ESBL-negative E. coli strains were found to be 100% and 99.7%, 80% and 90.6%, and 40% and 80.8%, respectively. Conclusion: In conclusion, ciprofloxacin resistance was high and resistance to fosfomycin and nitrofurantoin was very low in E. coli. Therefore, we assume that fosfomycin and nitrofurantoin can be used as empiric therapy for uncomplicated UTI caused by E. coli. Keywords: Urinary tract infection, extended spectrum beta lactamase, Escherichia coli, fosfomycin, nitrofurantoin, ciprofloxacin AbstractIn vitro Susceptibility Analysis of Escherichia coli Strains Isolated from Urinary Tract Infections to Fosfomycin, Nitrofurantoin and Ciprofloxacin

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“…Hücre duvarı biyosentezinde yapıtaşı olan N-asetil muramik asidin oluşmasını sağlayan sitoplazmik enolpirüvat transferaz enziminin geri dönüşümsüz olarak inhibisyonunu sağlayarak etki eder. Bu nedenle fosfomisin bakterisidal etki gösteren geniş antimikrobiyal aktiviteye sahip bir ajandır [6,7,13,14] .…”

Section: Fosfomisin Ilk Olarak 1969 Yılında İspanya'daunclassified

“…Ek olarak bizim sonuçlarımızla benzer olarak GSBL negatif izolatlarda fosfomisin direnci saptanmamıştır [13] . Ülkemizde yapılan benzer çalışmalardan bir diğerinde ise GSBL pozitif E. coli izolatlarında fosfomisin direnci 2005 yılında %3.4, 2011 yılında %2.2 olarak bulunmuş; GSBL negatif izolatlarda 2005 yılında fosfomisin direnci saptanmazken; 2011 yılında %0.9 olarak saptanmıştır [14] . "ECO-SENS Projesi" kapsamında (Kanada ve 16 Avrupa ülkesi) 2000 ve 2003 yıllarını kapsayan iki ayrı çalışmada, komplike olmamış ÜSİ'lerden izole edilen E. coli suşlarında fosfomisin direnci sırasıyla %0.4 ve %0.7 olarak saptanmıştır [15][16][17] .…”

Section: Fosfomisin Ilk Olarak 1969 Yılında İspanya'daunclassified

In Vitro Activity of Fosfomycin Trometamol Against Extended-Spectrum Beta-Lactamase Producing Escherichia coli Strains Isolated from Community-Acquired Urinary Tract Infections

Sönmezer¹,

Tülek²,

Köksal³

et al. 2016

FLORA

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Giriş: Escherichia coli toplum kaynaklı üriner sistem infeksiyonlarında en sık karşılaşılan etkendir. Genişlemiş spektrumlu beta-laktamaz (GSBL) üreten suşlar nedeniyle tedavide sorun yaşanmaktadır. Son yıllarda ülkemizde ve dünyada E. coli' nin etken olduğu toplum kaynaklı üriner sistem infeksiyonlarının tedavisinde sık kullanılan antibiyotiklere karşı duyarlılık azalmaktadır. Bu çalışmada, toplum kaynaklı üriner sistem infeksiyonlarından izole edilen GSBL pozitif E. coli suşlarında fosfomisinin in vitro etkinliğinin araştırılması amaçlanmıştır.

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Is there a rise in resistance rates to fosfomycin and other commonly used antibiotics in Escherichia coli-mediated urinary tract infections? A perspective for 2004 – 2011

Cited by 10 publications

References 42 publications

Evaluation of three-dose fosfomycin tromethamine in the treatment of patients with urinary tract infections: an uncontrolled, open-label, multicentre study

Evaluation of three-dose fosfomycin tromethamine in the treatment of patients with urinary tract infections: an uncontrolled, open-label, multicentre study

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

In Vitro Activity of Fosfomycin Trometamol Against Extended-Spectrum Beta-Lactamase Producing Escherichia coli Strains Isolated from Community-Acquired Urinary Tract Infections

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