Maintained susceptibility to fosfomycin in extra-hospitalary urinary isolates of Escherichia coli. Strong association of fosfomycin resistance with age and ESBL production.

E Hidalgo, A González-Torralba, J Ramón, J I Alós
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Abstract

Objective: Escherichia coli is isolated in most of uncomplicated community-acquired urinary tract infections (UTI) and fosfomycin is one of the treatments of choice. We analyzed the evolution of fosfomycin resistance in extrahospitalary E. coli urinary isolates and whether age and extended spectrum beta-lactamase (ESBL) production were associated to antibiotic resistance.

Methods: A retrospective descriptive study was conducted from January 2017 to December 2022 including E. coli isolates from extrahospitalary urine samples.

Results: The susceptibility to fosfomycin remained above 95% during the study period. ESBL production and age above 80 years were significantly associated with increased fosfomycin resistance. We also analyzed the consumption of fosfomycin and it remained stable, although it was higher in the population >65 years.

Conclusions: Greater resistance is observed in ESBL-producing strains and in patients over 65 years of age. A stable consumption of fosfomycin is associated with low resistance percentages maintained over the time.

院外尿路分离的大肠杆菌对磷霉素保持敏感性。磷霉素耐药性与年龄和ESBL产生密切相关。
目的:在大多数无并发症的社区获得性尿路感染(UTI)中分离出大肠杆菌,磷霉素是首选的治疗方法之一。我们分析了院外大肠杆菌尿分离株对磷霉素耐药性的演变,以及年龄和广谱β -内酰胺酶(ESBL)的产生是否与抗生素耐药性有关。方法:2017年1月至2022年12月进行回顾性描述性研究,包括从院外尿液样本中分离出的大肠杆菌。结果:研究期间对磷霉素的敏感性保持在95%以上。ESBL的产生和年龄在80岁以上与磷霉素耐药性的增加显著相关。我们还分析了磷霉素的消耗量,它保持稳定,尽管它在65岁以上的人群中较高。结论:在产esbl菌株和65岁以上患者中观察到更大的耐药性。磷霉素的稳定消耗与长期维持的低耐药百分比有关。
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