Antimicrobial Susceptibility of Multidrug-resistant Gram Negative Bacteria to Fosfomycin

Overview

Journal Eur J Clin Microbiol Infect Dis

Publisher Springer

Specialties Infectious Diseases
Microbiology

Date 2008 Jan 25

PMID 18214558

Citations 21

Authors

M E Falagas

M D Kanellopoulou

D E Karageorgopoulos

G Dimopoulos

P I Rafailidis

N D Skarmoutsou

E A Papafrangas

Affiliations

Soon will be listed here.

Abstract

We evaluated the antimicrobial activity of fosfomycin against a randomly selected sample of 30 Klebsiella pneumoniae, 30 Pseudomonas aeruginosa, and 30 Acinetobacter baumannii multidrug-resistant, clinical isolates from patients in a general tertiary care hospital in Athens, Greece. Standard laboratory methods were used for susceptibility testing to commonly used antibiotics and the detection of extended-spectrum-beta-lactamase (ESBL) and metallo-beta-lactamase (MBL) production. The minimum inhibitory concentration (MIC) of fosfomycin for each isolate was determined by the agar dilution method. All K. pneumoniae isolates were both ESBL and MBL producers; all P. aeruginosa isolates were ESBL producers. The K. pneumoniae strains had fosfomycin MICs distributed across a range of 8-64 microg/ml; MIC(50) was 16 microg/ml and MIC(90) 32 microg/ml. The fosfomycin MICs of the P. aeruginosa strains had a distribution across a range of 4 to over 512 microg/ml; MIC(50) was 32 microg/ml and MIC(90) 128 microg/ml. The fosfomycin MICs of the A. baumannii strains had a distribution across a range of 64 to over 512 microg/ml; MIC(50) was 256 microg/ml and MIC(90) more than 512 microg/ml. Although standardized fosfomycin MIC interpretative breakpoints for the species studied are lacking, the findings of our study support the idea that fosfomycin may be further investigated as one among a decreasing list of therapeutic options for the treatment of infections due to multidrug-resistant strains of, primarily, K. pneumoniae and, secondly, P. aeruginosa.

Citing Articles

Antimicrobial susceptibilities of clinical bacterial isolates from urinary tract infections to fosfomycin and comparator antibiotics determined by agar dilution method and automated micro broth dilution.

Dombach J, Smith N, Kottiri T, Schiller A, Kamau E Microbiol Spectr. 2025; 13(3):e0186024.

PMID: 39907466 PMC: 11878007. DOI: 10.1128/spectrum.01860-24.

Intravenous Fosfomycin for Systemic Multidrug-Resistant Infections.

Pipitone G, Di Bella S, Maraolo A, Granata G, Gatti M, Principe L Antibiotics (Basel). 2023; 12(12).

PMID: 38136687 PMC: 10741068. DOI: 10.3390/antibiotics12121653.

[UhpT mutation along with the presence of genes in the genome probably contributes to inherent fosfomycin resistance of ].

DA R, Zhou Y, Cheng Y, Lv J, Han B Nan Fang Yi Ke Da Xue Xue Bao. 2023; 43(7):1110-1115.

PMID: 37488793 PMC: 10366525. DOI: 10.12122/j.issn.1673-4254.2023.07.07.

In vitro and in vivo activity of ciprofloxacin/fosfomycin combination therapy against ciprofloxacin-resistant isolates.

Liu Y, Li H, Zhang Y, Ye Y, Gao Y, Li J Infect Drug Resist. 2019; 12:1619-1628.

PMID: 31354311 PMC: 6580129. DOI: 10.2147/IDR.S208071.

Epidemiology and molecular characterization of the antimicrobial resistance of in Chinese mink infected by hemorrhagic pneumonia.

Bai X, Liu S, Zhao J, Cheng Y, Zhang H, Hu B Can J Vet Res. 2019; 83(2):122-132.

PMID: 31097874 PMC: 6450165.

References

Kahlmeter G . An international survey of the antimicrobial susceptibility of pathogens from uncomplicated urinary tract infections: the ECO.SENS Project. J Antimicrob Chemother. 2002; 51(1):69-76. DOI: 10.1093/jac/dkg028. View

Yan J, Hsueh P, Lu J, Chang F, Ko W, Wu J . Characterization of acquired beta-lactamases and their genetic support in multidrug-resistant Pseudomonas aeruginosa isolates in Taiwan: the prevalence of unusual integrons. J Antimicrob Chemother. 2006; 58(3):530-6. DOI: 10.1093/jac/dkl266. View

Martinez-Martinez L, Rodriguez G, Pascual A, Suarez A, Perea E . In-vitro activity of antimicrobial agent combinations against multiresistant Acinetobacter baumannii. J Antimicrob Chemother. 1996; 38(6):1107-8. DOI: 10.1093/jac/38.6.1107. View

Schito G, Chezzi C, Nicoletti G, Moreddu M, Arcangeletti M, Stefani S . Susceptibility of frequent urinary pathogens to fosfomycin trometamol and eight other antibiotics: results of an Italian multicenter survey. Infection. 1992; 20 Suppl 4:S291-5. DOI: 10.1007/BF01710017. View

Reeves D . Fosfomycin trometamol. J Antimicrob Chemother. 1994; 34(6):853-8. DOI: 10.1093/jac/34.6.853. View

Frossard M, Joukhadar C, Erovic B, Dittrich P, Mrass P, Van Houte M . Distribution and antimicrobial activity of fosfomycin in the interstitial fluid of human soft tissues. Antimicrob Agents Chemother. 2000; 44(10):2728-32. PMC: 90143. DOI: 10.1128/AAC.44.10.2728-2732.2000. View

Gismondo M, Romeo M, Lo Bue A, Chisari G, Nicoletti G . Microbiological basis for the use of fosfomycin trometamol as single-dose therapy for simple cystitis. Chemioterapia. 1986; 5(4):278-82. View

Inouye S, Watanabe T, Tsuruoka T, Kitasato I . An increase in the antimicrobial activity in vitro of fosfomycin under anaerobic conditions. J Antimicrob Chemother. 1989; 24(5):657-66. DOI: 10.1093/jac/24.5.657. View

Dette G, Knothe H, Schonenbach B, Plage G . Comparative study of fosfomycin activity in Mueller-Hinton media and in tissues. J Antimicrob Chemother. 1983; 11(6):517-24. DOI: 10.1093/jac/11.6.517. View

10.

Giakkoupi P, Xanthaki A, Kanelopoulou M, Vlahaki A, Miriagou V, Kontou S . VIM-1 Metallo-beta-lactamase-producing Klebsiella pneumoniae strains in Greek hospitals. J Clin Microbiol. 2003; 41(8):3893-6. PMC: 179807. DOI: 10.1128/JCM.41.8.3893-3896.2003. View

11.

Falagas M, Michalopoulos A . Polymyxins: old antibiotics are back. Lancet. 2006; 367(9511):633-4. DOI: 10.1016/S0140-6736(06)68241-X. View

12.

Joukhadar C, Klein N, Dittrich P, Zeitlinger M, Geppert A, Skhirtladze K . Target site penetration of fosfomycin in critically ill patients. J Antimicrob Chemother. 2003; 51(5):1247-52. DOI: 10.1093/jac/dkg187. View

13.

Buisson Y, Bercion R, Mauclere P, Hugard L, SCHILL H . [Preliminary study of the antagonistic effects between fosfomycin and beta-lactams on Pseudomonas aeruginosa observed on the antibiogram]. Pathol Biol (Paris). 1988; 36(5 Pt 2):671-4. View

14.

Reguera J, Baquero F, Berenguer J, Martinez-Ferrer M, Martinez J . Beta-lactam-fosfomycin antagonism involving modification of penicillin-binding protein 3 in Pseudomonas aeruginosa. Antimicrob Agents Chemother. 1990; 34(11):2093-6. PMC: 172005. DOI: 10.1128/AAC.34.11.2093. View

15.

Tessier F, Quentin C . In vitro activity of fosfomycin combined with ceftazidime, imipenem, amikacin, and ciprofloxacin against Pseudomonas aeruginosa. Eur J Clin Microbiol Infect Dis. 1997; 16(2):159-62. DOI: 10.1007/BF01709477. View

16.

Dubois V, Arpin C, Noury P, Andre C, Coulange L, Quentin C . Prolonged outbreak of infection due to TEM-21-producing strains of Pseudomonas aeruginosa and enterobacteria in a nursing home. J Clin Microbiol. 2005; 43(8):4129-38. PMC: 1233937. DOI: 10.1128/JCM.43.8.4129-4138.2005. View

17.

KAHAN F, Kahan J, Cassidy P, KROPP H . The mechanism of action of fosfomycin (phosphonomycin). Ann N Y Acad Sci. 1974; 235(0):364-86. DOI: 10.1111/j.1749-6632.1974.tb43277.x. View

18.

Alarcon T, Lopez-Brea M . [Evolution of antimicrobial susceptibility of Acinetobacter baumannii clinical isolates]. Rev Esp Quimioter. 2001; 13(4):394-400. View

19.

Falagas M, Bliziotis I . Pandrug-resistant Gram-negative bacteria: the dawn of the post-antibiotic era?. Int J Antimicrob Agents. 2007; 29(6):630-6. DOI: 10.1016/j.ijantimicag.2006.12.012. View

20.

Petropoulou D, Tzanetou K, Syriopoulou V, Daikos G, Ganteris G, Malamou-Lada E . Evaluation of imipenem/imipenem+EDTA disk method for detection of metallo-beta-lactamase-producing Klebsiella pneumoniae isolated from blood cultures. Microb Drug Resist. 2006; 12(1):39-43. DOI: 10.1089/mdr.2006.12.39. View