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

  • 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
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 blaOXA-48, 15 isolates carried both blaOXA-48 and blaNDM; three had both blaOXA-48 and blaVIM and nine isolates had blaNDM alone. Four isolates carried only blaVIM and two isolates harbored blaIMP alone. One isolate co-harbored blaVIM and blaNDM. Among E. coli isolates, blaOXA-48 and blaNDM 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 blaOXA-48 carriers; 26.7% in isolates co-harbouring blaOXA-48 and blaNDM and 66.7% in blaNDM carriers. In E. coli, fosfomycin resistance was detected among 16.7% of the blaOXA-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.

Published
2020-04-30
How to Cite
1.
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
Section
Brief Original Articles