Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Susceptibility to Fosfomycin

Abstract

Introduction: The rising frequency of extended spectrum Beta-lactamase (ESBL) producing Enterobacteriaceae in recent years represents an important public health issue, with scarce effective alternatives for treatment. Several international studies have demonstrated very high in vitro susceptibility of these bacteria to fosfomycin. The
clinical efficiency of this treatment was tested on acute uncomplicated cystitis due to Escherichia coli subset, with encouraging results.
In Hospital Prof. Dr. Fernando Fonseca EPE (HFF) there has been
a progressive annual increase in the isolation of these pathogens.
The authors’ goal was to test the susceptibility of ESBL-producing
Enterobacteriaceae to fosfomycin in HFF and assess its possible therapeutic potential.
Material and methods: Prospective study (6 month period), in
which the susceptibility to fosfomycin of isolated ESBL-producing Enterobacteriaceae was tested. The VITEK 2® equipment
was used to identify the strains. The fosfomycin susceptibility was determined by disk diffusion method (Oxoid®). Statistical
analysis was performed using the Microsoft Excel® software.
Results: We identified 150 ESBL-producing Enterobacteriaceae, of which 52 % corresponded to Klebsiella pneumoniae and 44%
to Escherichia coli. Approximately 88% of Escherichia coli and
68% of Klebsiella pneumoniae were susceptible to fosfomycin.
Conclusions: Based on the data obtained at international level and in this study, the authors recommend the use of fosfomycin
for the treatment of acute uncomplicated cystitis caused by ESBL-producing Escherichia coli. Future clinical efficacy research
is needed in order to substantiate this practice and recommendation.