title: Activity of Fosfomycin against Extended-Spectrum-β-Lactamase-Producing Uropathogens in Patients in the Community and Hospitalized Patients.
abstract: Few oral antibiotics exist for the empirical treatment of extended-spectrum β-lactamase (ESBL) urinary tract infections (UTI). In this study, we sought to determine the activity of fosfomycin against ESBL-producing uropathogens from patients at 3 Veterans Affairs (VA) facilities between 2010 and 2013. Among the ESBL uropathogens, 19.9% were fosfomycin resistant. Klebsiella species were more likely than Escherichia coli to be resistant (46% versus 4%; P < 0.001). Fosfomycin remains active against a majority of the ESBL uropathogens, although resistance among Klebsiella spp. was higher than that in previous reports.
authors.affiliation: VA Boston Healthcare System, West Roxbury, Massachusetts, USA Boston University School of Medicine, Boston, Massachusetts, USA katherine.linsenmeyer@bmc.org.
authors.forename: Katherine
authors.initials: K
authors.lastname: Linsenmeyer
authors.affiliation: VA Boston Healthcare System, West Roxbury, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Strymish
authors.affiliation: VA Boston Healthcare System, West Roxbury, Massachusetts, USA Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Weir
authors.affiliation: VA Boston Healthcare System, West Roxbury, Massachusetts, USA Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Gretchen
authors.initials: G
authors.lastname: Berg
authors.affiliation: VA Boston Healthcare System, West Roxbury, Massachusetts, USA Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Brecher
authors.affiliation: VA Boston Healthcare System, West Roxbury, Massachusetts, USA Boston University School of Medicine, Boston, Massachusetts, USA National Center for Occupational Health and Infection Control, Gainesville, Florida, USA.
authors.forename: Kalpana
authors.initials: K
authors.lastname: Gupta
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D004926:Escherichia coli / Q000187:drug effects / Q000472:pathogenicity; D005578:Fosfomycin / Q000494:pharmacology* / Q000627:therapeutic use; D006787:Hospitals, Veterans; D006801:Humans; D007709:Klebsiella / Q000187:drug effects / Q000472:pathogenicity; D008297:Male; D008404:Massachusetts; D008826:Microbial Sensitivity Tests; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology*; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D005578:Fosfomycin; D001618:beta-Lactamases