SUsceptibility and Resistance to Fosfomycin and other antimicrobial agents among pathogens causing lower urinary tract infections: findings of the SURF study

Tutone, Michaela; Johansen, Truls E. Bjerklund; Cai, Tommaso; Mushtaq, Shazad; Livermore, David M.

doi:10.1016/j.ijantimicag.2022.106574

Cited by 26 publications

(19 citation statements)

References 29 publications

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“…The fosfomycin resistant rates reported in the current study among uropathogenic E. coli and those found in the latter studies are all lower than those reported against oral antibiotics commonly used to treat UTIs in Mexico, such as ciprofloxacin and cephalosporins [ 15 , 20 , 21 ]. The results of the current study are in agreement with the fosfomycin resistance rates found in Europe in the “Surveillance of sUsceptibility and Resistance to Fosfomycin in comparison with other antimicrobial agents study” (SURF) [ 22 ], where fosfomycin and nitrofurantoin were the oral antibiotics with the lowest resistance against uropathogenic E. coli . However, larger studies in Mexico are needed to confirm if fosfomycin is a viable option in the empiric treatment of UTIs, as suggested by our in vitro results.…”

Section: Discussionsupporting

confidence: 89%

Emergence of Fosfomycin Resistance by Plasmid-Mediated fos Genes in Uropathogenic ESBL-Producing E. coli Isolates in Mexico

et al. 2022

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Fosfomycin is currently a viable option against urinary tract infections, particularly against extended-spectrum β-lactamases (ESBL)-producing E. coli, due to its unique mechanism of action and its low resistance among bacteria. The objective of this study was to investigate two of the three most common mechanisms of resistance against this antibiotic among 350 ESBL-producing E. coli strains isolated from the urine of Mexican patients. The prevalence of fosfomycin resistance in our study was 10.9% (38/350). Of all resistant isolates analyzed, 23 (60.5%) were identified as fos-producing organisms, with 14 strains carrying fosA3 and 9, fosA1. Additionally, 11 (28.9%) fosfomycin-resistant isolates presented resistance due to impaired antibiotic transport and 8 (21.0%) both mechanisms. No resistance mechanism investigated in the study was found on 12 strains. All 38 confirmed ESBL-producing isolates carried a blaCTX-M subtype, 36 (94.5%) belonged to the O25b-ST131 clone, and all of them were able to transfer the fosfomycin resistance trait to recipient strains horizontally. This is the first study in Mexico demonstrating a plasmid-mediated fosfomycin resistance mechanism among clinical E. coli strains. Since our results suggest a strong association among fos and blaCTX-Mgenes and ST131 clones in uropathogenic E. coli, plasmid-mediated fosfomycin resistance should be closely monitored.

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Section: Discussionsupporting

confidence: 89%

Emergence of Fosfomycin Resistance by Plasmid-Mediated fos Genes in Uropathogenic ESBL-Producing E. coli Isolates in Mexico

et al. 2022

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“…A similar study conducted by M. Tutone, T.E. Bjerklund Johansen, T.Cai et al, (13) in 2022 across Europe found fosfomycin was sensitive in 96.4% E.Coli isolated from urine samples. Our study which focussed on two urinary pathogens E.Coli & Enterococcus species showed overall 92.5% sensitivity to fosfomycin.…”

Section: Discussionmentioning

confidence: 57%

“…Our study was divided into 5 age groups (0-5), (6)(7)(8)(9)(10)(11)(12)(13)(14)(15), , (41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60) (40) (2022) conducted a study in Jaipur (India) & reported UTIs to be present predominantly in females then males, (60.7%) UTI in females and (39.3%) UTIs in males. A similar study was conducted by Banerjee, et al, (32) (2017) West Bengal (India) in their study they also found that females more prone to UTI then in males, they found (73.33%) UTIs in females and (26.67%) UTIs in males.…”

Section: Discussionmentioning

confidence: 99%

“…In our study the percentage of E. Coli was 79.4% among all the gram negative bacteria. M. Tutone et al, (13) conducted a study in London (2022) and found that E. Coli was the predominant microbe among the all gram negative organisms (72.5%). A similar study was conducted by Crraro-Eduardo et al, (42) in Brazil in (2021) they also found that E.Coli was the more frequently isolated gram negative bacteria (68.8%).…”

Section: Discussionmentioning

confidence: 99%

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Study of Fosfomycin Sensitivity in Various Bacterial Isolates in Patients of Urinary Tract Infections Attending in a Tertiary Care Hospital in Kashmir Region, India

2023

IRJMETS

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Background: Urinary Tract Infections which are the second most common infections after respiratory tract infection in community and hospitals are defined as the infections of any part of urinary system by microbial invasion. The bacteria which cause urinary tract infections are Escherichia coli, Klebsiella, Proteus, Enterococcus, staphylococcus aureus, And Staphylococcus saprophyticus. But the most frequent causative agent of UTIs is E.Coli and Enterococcus. Every year about 150 million patients become victims of UTI with the disease predominantly affecting females, 70% of whom are infected by the time they reach 24 years of age. The prevalence of UTIs gets increased 5-10% during pregnancy due to hormonal and physiological changes. Material and Method:The study was conducted prospectively in the department of Microbiology SKIMS Bemina, Srinagar; a tertiary care hospital from June 2022 NOV 2022 .A total of 622 samples were collected from the patients, in which 194 were culture positive and out of 194 culture positive, 162 samples showed significant growth. In this study (Inoculation, Incubation, Isolation, Inspection and Identification) and then Antibiotic susceptibility testing of isolates were performed by standard Microbiological techniques. Results: out of 622 urine samples 194(31.1% ) were culture positive. GNB (55.1%) were predominantly isolated followed by (31.9%) GPC, (6.1%) showed growth of Candida and (6.7%) showed polymicrobial growth. Among all the isolates E.Coli (79.4%) and Enterococcus (79.03%) were the most frequently isolated with sensitivity to fosfomycin (92.90%) & (91.80%).and the overall sensitivity of fosfomycin was (92.50%). Conclusion: From this study the following conclusion can be drawn, fosfomycin is a good oral antibiotic for uncomplicated urinary tract infections which includes both 'hospital acquired' and 'community acquired'. Fosfomycin has unique mechanism of action which makes cross-resistance very uncommon and allows for better synergy with other antibiotics. It has remarkably great antimicrobial activity against drug resistant pathogens.

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“…Many bacterial species can develop various forms of resistance to fosfomycin, including changes or mutations in the biosynthesis pathway of the target molecule of the antibiotic, decreased fosfomycin uptake and fosfomycin inactivation reactions [ 2 , 4 ]. However, despite more than 30 years of use, there are low rates of resistance to fosfomycin which has preserved its high activity against multidrug and extensively drug resistant isolates, including extended-spectrum β lactamase-producing Escherichia coli strains [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Fosfomycin Pharmacokinetic Profile in Plasma and Urine and Quantitative Estimation in Prostate and Seminal Vesicles after One and Two Consecutive Doses of Oral Fosfomycin Trometamol in Healthy Male Volunteers

Stefano¹,

Radicioni²,

Morano³

et al. 2022

Antibiotics

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The present Phase I study investigated, for the first time, fosfomycin pharmacokinetics in humans after two 3 g doses of fosfomycin trometamol administered 27 h apart, according to the dose regimen recommended for the prophylactic indication for transrectal prostate biopsy in adult men. Plasma, urine and seminal plasma concentrations were measured after one and two consecutive doses in 24 healthy men, representative of the target population of the prophylactic indication. Prostate and seminal vesicle concentrations were estimated based on seminal plasma concentrations using a one-step regression method. The exposure to fosfomycin was very similar in rate (Cmax, tmax) after one and two doses. The AUC showed a minimal increment. On average, the apparent volume of distribution was high (>100 L), and the mean clearance had an intermediate value. The total amount and dose fraction of fosfomycin excreted in urine showed a small increment after two doses. The renal clearance was about 5 L/h. The fosfomycin concentration in the prostate and seminal vesicles showed that the antibiotic increased on average after two consecutive doses. This result confirmed the ability of fosfomycin to distribute into the prostate and into seminal vesicles after one single dose and that a two consecutive dose regimen increases the antibiotic availability inside these peripheral tissues.

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SUsceptibility and Resistance to Fosfomycin and other antimicrobial agents among pathogens causing lower urinary tract infections: findings of the SURF study

Cited by 26 publications

References 29 publications

Emergence of Fosfomycin Resistance by Plasmid-Mediated fos Genes in Uropathogenic ESBL-Producing E. coli Isolates in Mexico

Emergence of Fosfomycin Resistance by Plasmid-Mediated fos Genes in Uropathogenic ESBL-Producing E. coli Isolates in Mexico

Study of Fosfomycin Sensitivity in Various Bacterial Isolates in Patients of Urinary Tract Infections Attending in a Tertiary Care Hospital in Kashmir Region, India

Fosfomycin Pharmacokinetic Profile in Plasma and Urine and Quantitative Estimation in Prostate and Seminal Vesicles after One and Two Consecutive Doses of Oral Fosfomycin Trometamol in Healthy Male Volunteers

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