Evaluation of fosfomycin susceptibility using CLSI vs EUCAST criteria among multi drug resistant uropathogens in a tertiary care Hospital.

IF 1.9 Q4 MICROBIOLOGY

Iranian Journal of Microbiology Pub Date : 2026-02-01 DOI:10.18502/ijm.v18i1.20908

Arun Sachu, Alice David

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引用次数: 0

Abstract

Background and objectives: Urinary Tract Infections (UTIs) are most frequently caused by uropathogenic Escherichia coli, which accounts for approximately 80% of the cases. Other causative agents include Klebsiella spp., Proteus spp., Enterobacter spp., Enterococcus spp., and Staphylococcus saprophyticus. The main objectives of the study were to estimate the in vitro antimicrobial activity of fosfomycin against multidrug-resistant uropathogens (MDR) isolated from patients with suspected UTI using CLSI and EUCAST criteria and to describe the antimicrobial susceptibility pattern of uropathogens isolated during the study.

Materials and methods: This was a descriptive study in which a total of 900 urine samples were collected from patients presenting with physician-assessed signs and symptoms suggestive of a UTI. Only samples exhibiting significant bacteriuria that were also multidrug-resistant (MDR) were included. Although fosfomycin disk diffusion criteria, according to CLSI and EUCAST, are only validated for E. coli, susceptibility among other Gram-negative bacteria was also interpreted using the same criteria. This represents a major limitation of the study.

Results: In the study, 251 samples grew multi drug resistant organisms. Only 57% of the Gram-negative isolates were sensitive according to EUCAST guidelines, while 87.6% of all isolates were sensitive by CLSI criteria. Among the 161 carbapenem-resistant isolates, 135 (83.9%) were fosfomycin-susceptible and 18 (11.2%) were resistant according to CLSI. In contrast, by EUCAST criteria, only 40 (24.9%) isolates were fosfomycin-susceptible, and the remaining 121 (75.1%) were resistant.

Conclusion: Our study showed that using fosfomycin disc diffusion criteria of E. coli for other organisms is not ideal; therefore, performing an alternative form of susceptibility testing for non-E. coli isolates is recommended. Continuous monitoring of fosfomycin susceptibility is warranted to detect any emerging resistance and to guide its clinical application.

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应用CLSI和EUCAST标准评价三级医院多重耐药尿路病原菌对磷霉素的敏感性

背景和目的：尿路感染（uti）最常由尿路致病性大肠杆菌引起，约占病例的80%。其他病原体包括克雷伯氏菌、变形杆菌、肠杆菌、肠球菌和腐生葡萄球菌。本研究的主要目的是使用CLSI和EUCAST标准评估磷霉素对疑似尿路感染患者分离的多药耐药尿路病原体（MDR）的体外抗菌活性，并描述研究中分离的尿路病原体的抗菌敏感性模式。材料和方法：这是一项描述性研究，共收集了900份尿液样本，来自有医生评估的尿路感染体征和症状的患者。仅包括具有多药耐药（MDR）的显著菌尿样本。尽管根据CLSI和EUCAST，磷霉素圆盘扩散标准仅适用于大肠杆菌，但其他革兰氏阴性菌的敏感性也使用相同的标准进行了解释。这是本研究的一个主要局限性。结果：251份样品中存在多重耐药菌。根据EUCAST指南，只有57%的革兰氏阴性分离株敏感，而根据CLSI标准，所有分离株中有87.6%敏感。在161株碳青霉烯耐药菌株中，135株（83.9%）对磷霉素敏感，18株（11.2%）耐药。相比之下，根据EUCAST标准，只有40株（24.9%）对磷霉素敏感，其余121株（75.1%）耐药。结论：我们的研究表明，用磷霉素圆盘扩散法鉴定大肠杆菌对其他微生物的影响并不理想；因此，对非e。推荐使用分离大肠杆菌。持续监测磷霉素敏感性是必要的，以发现任何新出现的耐药性，并指导其临床应用。

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来源期刊

Iranian Journal of Microbiology MICROBIOLOGY-

CiteScore

2.40

自引率

7.10%

发文量

审稿时长

12 weeks

期刊介绍： The Iranian Journal of Microbiology (IJM) is an international, multi-disciplinary, peer-reviewed journal that provides rapid publication of the most advanced scientific research in the areas of basic and applied research on bacteria and other micro-organisms, including bacteria, viruses, yeasts, fungi, microalgae, and protozoa concerning the development of tools for diagnosis and disease control, epidemiology, antimicrobial agents, clinical microbiology, immunology, Genetics, Genomics and Molecular Biology. Contributions may be in the form of original research papers, review articles, short communications, case reports, technical reports, and letters to the Editor. Research findings must be novel and the original data must be available for review by the Editors, if necessary. Studies that are preliminary, of weak originality or merely descriptive as well as negative results are not appropriate for the journal. Papers considered for publication must be unpublished work (except in an abstract form) that is not under consideration for publication anywhere else, and all co-authors should have agreed to the submission. Manuscripts should be written in English.