Fosfomycin susceptibility among multidrug resistant and extended spectrum β-Lactamase producing uropathogenic Escherichia coli isolates at a tertiary care hospital of Western India

Abstract

Introduction: Urinary tract infections are mostly treated empirically with broad-spectrum antibiotics which have resulted in development of multi-drug resistant strains. Limited options of newer antibiotics have necessitated the reintroduction of some old antimicrobial agents such as fosfomycin. Aim: To evaluate the in-vitro activity of fosfomycin against uropathogenic E.coli. Method: A total of 145 E.coli isolates were identified by conventional microbiological procedures and antimicrobial susceptibility performed by Kirby-Bauer disk diffusion method. They were screened for extended spectrum β-lactamase (ESBL) production and screen positives were confirmed by phenotypic confirmatory test (CLSI). Results: Out of 145 isolates, 91 (62.76 %) were found in males and 54 (37.24%) from females. Majority of the isolates were detected in the age group of 21-30 years 48.96%. A very high susceptibility of 94.48% was observed with fosfomycin. Suceptibility to tigecycline and nitrofurantoin was 87.58 % and 77.24 % respectively. Multi-drug resistance was observed in 85.51% isolates and 45.51% were ESBL producers. Conclusion: Fosfomycin showed an excellent in vitro activity against MDR and ESBL producing E.coli, therefore it should be considered as a potential therapeutic alternative in the treatment of UTI.