In vitro susceptibility of OXA-48, NDM, VIM and IMP enzyme- producing Klebsiella spp. and Escherichia coli to fosfomycin

Selay Demirci-Duarte; Tugce Unalan-Altintop; Zeynep Gulay; Ayse Nur Sari Kaygisiz; Asli Cakar; Deniz Gur

doi:10.3855/jidc.12456

In vitro susceptibility of OXA-48, NDM, VIM and IMP enzyme- producing Klebsiella spp. and Escherichia coli to fosfomycin

Authors

Selay Demirci-Duarte Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey
Tugce Unalan-Altintop Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey
Zeynep Gulay Department of Medical Microbiology, Dokuz Eylul University Faculty of Medicine, Balcova, Izmir, Turkey
Ayse Nur Sari Kaygisiz Department of Medical Microbiology, Dokuz Eylul University Faculty of Medicine, Balcova, Izmir, Turkey
Asli Cakar Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey
Deniz Gur Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey

DOI:

https://doi.org/10.3855/jidc.12456

Keywords:

fosfomycin, agar dilution, carbapenemase

Abstract

Introduction: Infections caused by Carbapenemase-producing Enterobacterales (CPE) are an important public health issue. Intravenous fosfomycin can be considered as an alternative for the treatment of serious infections caused by CPE. In this study, in vitro activity of fosfomycin was investigated among CPE isolates.

Methodology: Overall, 158 clinically relevant isolates obtained from 18 hospitals of 13 cities in Turkey with predetermined carbapenemase types were evaluated in the study, including Escherichia coli (n = 19) and Klebsiella spp. (n = 139). In vitro activity of fosfomycin was determined with agar dilution method. Among Klebsiella spp., 104 harbored bla_OXA-48, 15 isolates carried both bla_OXA-48and bla_NDM; three had both bla_OXA-48and bla_VIM and nine isolates had bla_NDM alone. Four isolates carried only bla_VIM and two isolates harbored bla_IMP alone. One isolate co-harbored bla_VIM and bla_NDM. Among E. coli isolates, bla_OXA-48 and bla_NDM were carried by 18 and one isolates, respectively.

Results: Resistance to fosfomycin was detected in 43.7% of the isolates. Among Klebsiella spp. and E. coli, these rates were 46.8% and 21.1%, respectively. In Klebsiella spp. resistance to fosfomycin was 49.5% in bla_OXA-48 carriers; 26.7% in isolates co-harbouring bla_OXA-48 and bla_NDM and 66.7% in bla_NDM carriers. In E. coli, fosfomycin resistance was detected among 16.7% of the bla_OXA-48 carriers.

Conclusions: High level of fosfomycin resistance in these isolates may be attributable to the fact that these isolates are multidrug resistant. The genetic background of resistance should also be investigated in order to understand the co-occurrence and transfer of resistance among the CPE.

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Published

2020-04-30

How to Cite

Demirci-Duarte S, Unalan-Altintop T, Gulay Z, Sari Kaygisiz AN, Cakar A, Gur D (2020) In vitro susceptibility of OXA-48, NDM, VIM and IMP enzyme- producing Klebsiella spp. and Escherichia coli to fosfomycin. J Infect Dev Ctries 14:394–397. doi: 10.3855/jidc.12456

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Issue

Vol. 14 No. 04: April 2020

Section

Brief Original Articles

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