Hoşbul Tuğrul, Ozyurt Mustafa, Baylan Orhan, Bektöre Bayhan, Ardiç Nurittin, Ceylan Suileyman, Erdemoğlu Ali, Haznedaroğlu Tunçer
GATA Haydarpaşa Eğitim Hastanesi, Tibbi Mikrobiyoloji Servisi, Istanbul.
Mikrobiyol Bul. 2009 Oct;43(4):645-9.
Although in certain countries in Europe fosfomycin trometamol (FT) has been used for many years, in Turkey FT has become available in recent years. FT has a broad-spectrum activity against most of gram-positive and gram-negative bacteria. In this study, we aimed to evaluate the effect of FT, a new alternative antimicrobial agent in the treatment of patients with Escherichia coli related uncomplicated lower urinary tract infection (UTI). For this purpose, between May 2007-July 2008, FT susceptibility of 771 nonduplicate E. coli strains, isolated from urine samples of patients with uncomplicated lower UTI (bacteria > or = 10(5) cfu/mL), was determined by disk diffusion method according to Clinical and Laboratory Standarts Institute (CLSI) criteria. Simultaneously, extended-spectrum beta-lactamase (ESBL) detection was performed by double disk synergy test in all isolates. Among all E. coli isolates, FT resistance rate was 0.4% (3/771) and ESBL positivity was 19.5% (150/771). The rates of ESBL producing strains isolated from inpatients and outpatients were 34.1% (70/205) and 14.1% (80/566), respectively, and the difference was found statistically significant (p = 0.0001). Although resistance to FT was not detected in non-ESBL producing E. coli isolates (n = 621), FT resistance rate was 2% (3/150) in ESBL producers. As far as the current literature was concerned this was the largest scale study investigating the activity of FT in Turkey. Resistance to antimicrobials that had been used frequently as therapeutic options for the treatment of E. coli related UTIs, has been increasing. In the present study high susceptibility rates to FT was determined for urinary E. coli isolates. In conclusion, these data suggest that FT may be a good alternative for the treatment of uncomplicated UTIs as a first line antimicrobial agent.
尽管在欧洲某些国家，磷霉素氨丁三醇（FT）已使用多年，但在土耳其，FT近年来才开始可用。FT对大多数革兰氏阳性和革兰氏阴性细菌具有广谱活性。在本研究中，我们旨在评估FT这种新型替代抗菌药物治疗大肠杆菌相关性单纯性下尿路感染（UTI）患者的效果。为此，在2007年5月至2008年7月期间，根据临床和实验室标准协会（CLSI）标准，采用纸片扩散法测定了从单纯性下UTI患者尿液样本（细菌≥10⁵ cfu/mL）中分离出的771株非重复大肠杆菌菌株对FT的敏感性。同时，对所有分离株进行双纸片协同试验检测超广谱β-内酰胺酶（ESBL）。在所有大肠杆菌分离株中，FT耐药率为0.4%（3/771），ESBL阳性率为19.5%（150/771）。从住院患者和门诊患者中分离出的产ESBL菌株率分别为34.1%（70/205）和14.1%（80/566），差异有统计学意义（p = 0.0001）。虽然在非产ESBL的大肠杆菌分离株（n = 621）中未检测到对FT的耐药性，但产ESBL菌株中FT耐药率为2%（3/150）。就目前的文献而言，这是土耳其规模最大的一项研究FT活性的研究。作为治疗大肠杆菌相关性UTIs的常用治疗选择的抗菌药物的耐药性一直在增加。在本研究中，确定了尿液大肠杆菌分离株对FT的高敏感性率。总之，这些数据表明，FT作为一线抗菌药物可能是治疗单纯性UTIs的良好替代药物。
