Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, Greece.
Int J Antimicrob Agents. 2010 Mar;35(3):240-3. doi: 10.1016/j.ijantimicag.2009.10.019.
The advancing antimicrobial drug resistance among Enterobacteriaceae renders the evaluation of potential novel therapeutic options necessary. We sought to evaluate the in vitro antimicrobial activity of fosfomycin against multidrug-resistant (MDR) Enterobacteriaceae isolates. Antimicrobial susceptibility to fosfomycin and 12 additional antibiotics of MDR Enterobacteriaceae isolates collected between November 2007 and April 2009 at the University Hospital of Heraklion, Crete, Greece, was examined using the Etest method. A total of 152 MDR Enterobacteriaceae isolates were studied, including Klebsiella pneumoniae (76.3%), Escherichia coli (17.1%), Proteus mirabilis (4.6%) and other species (2.0%). Antimicrobial susceptibility rates were highest for fosfomycin (92.8%), tigecycline (92.1%) and colistin (73.0%) followed by imipenem (35.5%), tetracycline (20.4%), gentamicin (19.7%), trimethoprim/sulfamethoxazole (12.5%) and ciprofloxacin (10.5%). Of the 152 isolates, 85 (55.9%) were extensively drug-resistant (XDR), of which 78 (91.8%) remained susceptible to fosfomycin. Susceptibility to fosfomycin of the 79 carbapenemase-producing, 34 extended-spectrum beta-lactamase-producing and 24 metallo-beta-lactamase-producing isolates was 94.9%, 94.1% and 83.3%, respectively. In conclusion, in this study fosfomycin exhibited good in vitro antimicrobial activity against MDR and XDR Enterobacteriaceae. We suggest further evaluation of the potential clinical utility of fosfomycin against infections caused by these pathogens.
肠杆菌科的抗菌药物耐药性不断发展，使得评估潜在的新型治疗选择变得必要。我们旨在评估磷霉素对多药耐药（MDR）肠杆菌科分离株的体外抗菌活性。使用 Etest 方法检测了 2007 年 11 月至 2009 年 4 月间在希腊克里特岛伊拉克利翁大学医院收集的 152 株 MDR 肠杆菌科分离株对磷霉素和其他 12 种抗生素的药敏性。共研究了 152 株 MDR 肠杆菌科分离株，包括肺炎克雷伯菌（76.3%）、大肠埃希菌（17.1%）、奇异变形杆菌（4.6%）和其他种属（2.0%）。对磷霉素（92.8%）、替加环素（92.1%）和黏菌素（73.0%）的药敏率最高，其次是亚胺培南（35.5%）、四环素（20.4%）、庆大霉素（19.7%）、复方磺胺甲噁唑（12.5%）和环丙沙星（10.5%）。在 152 株分离株中，85 株（55.9%）为广泛耐药（XDR），其中 78 株（91.8%）对磷霉素仍敏感。79 株产碳青霉烯酶、34 株产超广谱β-内酰胺酶和 24 株产金属β-内酰胺酶的分离株对磷霉素的药敏率分别为 94.9%、94.1%和 83.3%。总之，在本研究中，磷霉素对 MDR 和 XDR 肠杆菌科具有良好的体外抗菌活性。我们建议进一步评估磷霉素对这些病原体引起的感染的潜在临床应用价值。
