Sreenivasan Srirangaraj, Kali Arunava, Pravin Charles M V, Kunigal Seetha
Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed University), Puducherry, India.
J Lab Physicians. 2019 Jul-Sep;11(3):249-252. doi: 10.4103/JLP.JLP_27_19.
The increasing drug resistance among Gram-negative uropathogens and a lack of effective oral antibiotics have limited the therapeutic options available for urinary tract infections (UTIs). This shortage of newer antibiotics has paved the way for considering the use of older antibiotics such as fosfomycin. This study aims to evaluate the susceptibility of isolates to fosfomycin.
In this descriptive study conducted over a period of 6 months, we processed 1500 urine samples. The isolates were subjected to susceptibility testing to fosfomycin, in addition to the regularly used urinary antibiotics, by Kirby-Bauer disc-diffusion method.
Of 1500 urine samples processed, 582 samples yielded the growth of pathogens. accounted for 392 (67.3%) of the isolates. Among these isolates, lower rates of resistance were observed for imipenem (4.1%) and fosfomycin (13.3%). Relatively higher rates of resistance were observed for nitrofurantoin (35.5%) and amikacin (30.9%). Nalidixic acid, norfloxacin, gentamicin, cefotaxime, and cotrimoxazole showed a high resistance rate of 82.7%, 69.6%, 52.3%, 69.1%, and 71.4%, respectively. All antibiotics, except fosfomycin, were in routine clinical use in our hospital. The low resistance (13.3%) to fosfomycin is indicative of its utility as an excellent urinary antibiotic.
Uropathogenic isolates displayed excellent susceptibility to fosfomycin. These findings suggest the unexplored potential of fosfomycin as a superior therapeutic option for treating uncomplicated UTI.
革兰氏阴性尿路病原体耐药性不断增加,且缺乏有效的口服抗生素,这限制了尿路感染(UTIs)的治疗选择。新型抗生素的短缺为考虑使用诸如磷霉素等老一代抗生素铺平了道路。本研究旨在评估分离株对磷霉素的敏感性。
在这项为期6个月的描述性研究中,我们处理了1500份尿液样本。除了常规使用的尿路抗生素外,通过 Kirby-Bauer 纸片扩散法对分离株进行了磷霉素敏感性测试。
在处理的1500份尿液样本中,582份样本培养出病原体。其中革兰氏阴性菌占392株(67.3%)。在这些分离株中,亚胺培南(4.1%)和磷霉素(13.3%)的耐药率较低。呋喃妥因(35.5%)和阿米卡星(30.9%)的耐药率相对较高。萘啶酸、诺氟沙星、庆大霉素、头孢噻肟和复方新诺明的耐药率分别高达82.7%、69.6%、52.3%、69.1%和71.4%。除磷霉素外,所有抗生素均在我院常规临床使用。对磷霉素的低耐药率(13.3%)表明其作为一种优良的尿路抗生素的效用。
尿路致病性革兰氏阴性菌分离株对磷霉素表现出良好的敏感性。这些发现表明磷霉素作为治疗非复杂性UTI的一种优越治疗选择具有尚未被发掘的潜力。