Tumturk Ayhanim, Tonyali Senol, Tezer Tekce Ayse Yasemin, Isikay Levent, Cime Hakan
University of Health Sciences, Clinic of Infectious Diseases, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
University of Health Sciences, Clinic of Urology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
J Infect Dev Ctries. 2019 Jan 31;13(1):73-76. doi: 10.3855/jidc.10658.
We aimed to demonstrate if fosfomycin tromethamine (FT) treatment could be the treatment of choice in ESBL-producing Enterobacteriaceae strains as an alternative to carbapenem particularly in patients who we would like to treat on an outpatient basis.
We retrospectively analyzed the medical records of all patients who admitted to infectious disease outpatient clinic with complaints of dysuria and frequency and received FT for lower UTI between May 2016 and May 2017.
A total of 48 patients, 19 females (39.6%) and 29 males (60.4%), with a mean age of 62.5 (ranging from 27 to 85) years were included the study. 26 (76.4%) of patients with a history of urinary operation or intervention had also a history of antibiotic use within the past 3 months. The isolated pathogens included Escherichia Coli (n = 32), Klebsiella spp. (n = 12), Enterobacter spp. (n = 4). The overall microbiological response after treatment was 70.8% (34/48) and the clinical response was 75% (36/48). Clinical and microbiological response rates of patients with and without urinary operation/intervention, diabetes mellitus, history of antibiotic use and malignancy were found similar (p > 0.05). However, patients with a urinary stone disease history had significantly higher response rates than those without a urinary stone disease history (P = 0.042).
Oral fosfomycin tromethamine might be the treatment of choice in ESBL-producing enterobactericea related UTIs especially caused by Escherichia Coli.
我们旨在证明，对于产超广谱β-内酰胺酶（ESBL）的肠杆菌科菌株，磷霉素氨丁三醇（FT）治疗是否可作为碳青霉烯类药物的替代选择，特别是对于我们希望在门诊治疗的患者。
我们回顾性分析了2016年5月至2017年5月期间因尿痛和尿频主诉入住传染病门诊并接受FT治疗下尿路感染的所有患者的病历。
共有48例患者纳入研究，其中女性19例（39.6%），男性29例（60.4%），平均年龄62.5岁（范围27至85岁）。有泌尿系统手术或干预史的患者中，26例（76.4%）在过去3个月内也有抗生素使用史。分离出的病原体包括大肠杆菌（n = 32）、克雷伯菌属（n = 12）、肠杆菌属（n = 4）。治疗后的总体微生物学反应率为70.8%（34/48），临床反应率为75%（36/48）。有无泌尿系统手术/干预、糖尿病、抗生素使用史和恶性肿瘤的患者的临床和微生物学反应率相似（p > 0.05）。然而，有尿路结石病史的患者的反应率明显高于无尿路结石病史的患者（P = 0.042）。
口服磷霉素氨丁三醇可能是产ESBL肠杆菌科相关尿路感染，尤其是由大肠杆菌引起的尿路感染的治疗选择。
