title: In vitro activity of fosfomycin against ciprofloxacin-resistant or extended-spectrum beta-lactamase-producing Escherichia coli isolated from urine and blood.
abstract: In this study, we evaluated the in vitro activity of fosfomycin and 7 other comparator agents against 307 Escherichia coli isolates including ciprofloxacin-resistant or extended-spectrum beta-lactamase (ESBL)-producing isolates. Bacterial isolates were collected from urine and blood from patients at a Korean tertiary-care hospital. Among 307 E. coli isolates, 30.3% were resistant to ciprofloxacin (MIC(90), >32 mg/L) and 7.8% produced ESBLs. The highest resistance rate was observed in ampicillin (69.7%), followed by trimethoprim-sulfamethoxazole (43.0%), and then amoxicillin-clavulanate (32.2%). All isolates were susceptible to imipenem (MIC(90), 0.125 mg/L). All but 1 isolate was susceptible to fosfomycin (MIC(90), 16 mg/L), regardless of the collected sources, ciprofloxacin resistance, and ESBL production. The data showed excellent activity of fosfomycin against E. coli isolates including fluoroquinolone-resistant strains. The clinical usefulness of fosfomycin, as a 1st-line therapy for urinary tract infection, should be evaluated further, especially in regions where ciprofloxacin resistance rates are high.
authors.affiliation: Asian-Pacific Research Foundation for Infectious Diseases, Seoul 135-710, Korea.
authors.forename: Kwan Soo
authors.initials: KS
authors.lastname: Ko
authors.forename: Ji Yoeun
authors.initials: JY
authors.lastname: Suh
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.forename: Mi Young
authors.initials: MY
authors.lastname: Lee
authors.forename: Won Sup
authors.initials: WS
authors.lastname: Oh
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Kwon
authors.forename: Dong Sik
authors.initials: DS
authors.lastname: Jung
authors.forename: Nam Yong
authors.initials: NY
authors.lastname: Lee
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Song
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001769:Blood / Q000382:microbiology*; D002939:Ciprofloxacin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology; D005578:Fosfomycin / Q000494:pharmacology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D014552:Urinary Tract Infections / Q000382:microbiology; D014556:Urine / Q000382:microbiology*; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D005578:Fosfomycin; D002939:Ciprofloxacin; D001618:beta-Lactamases