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

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 a...

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Main Authors: Selay Demirci-Duarte, Tugce Unalan-Altintop, Zeynep Gulay, Ayse Nur Sari Kaygisiz, Asli Cakar, Deniz Gur
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2020-04-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/12456
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author Selay Demirci-Duarte
Tugce Unalan-Altintop
Zeynep Gulay
Ayse Nur Sari Kaygisiz
Asli Cakar
Deniz Gur
author_facet Selay Demirci-Duarte
Tugce Unalan-Altintop
Zeynep Gulay
Ayse Nur Sari Kaygisiz
Asli Cakar
Deniz Gur
author_sort Selay Demirci-Duarte
collection DOAJ
description 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.
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spelling doaj-art-8f05e013fe024d19b20b528ee3c679ad2025-08-20T02:57:04ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802020-04-01140410.3855/jidc.12456In vitro susceptibility of OXA-48, NDM, VIM and IMP enzyme- producing Klebsiella spp. and Escherichia coli to fosfomycinSelay Demirci-Duarte0Tugce Unalan-Altintop1Zeynep Gulay2Ayse Nur Sari Kaygisiz3Asli Cakar4Deniz Gur5Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, TurkeyDepartment of Medical Microbiology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, TurkeyDepartment of Medical Microbiology, Dokuz Eylul University Faculty of Medicine, Balcova, Izmir, TurkeyDepartment of Medical Microbiology, Dokuz Eylul University Faculty of Medicine, Balcova, Izmir, TurkeyDepartment of Medical Microbiology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, TurkeyDepartment of Medical Microbiology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey 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. https://jidc.org/index.php/journal/article/view/12456fosfomycinagar dilutioncarbapenemase
spellingShingle Selay Demirci-Duarte
Tugce Unalan-Altintop
Zeynep Gulay
Ayse Nur Sari Kaygisiz
Asli Cakar
Deniz Gur
In vitro susceptibility of OXA-48, NDM, VIM and IMP enzyme- producing Klebsiella spp. and Escherichia coli to fosfomycin
Journal of Infection in Developing Countries
fosfomycin
agar dilution
carbapenemase
title In vitro susceptibility of OXA-48, NDM, VIM and IMP enzyme- producing Klebsiella spp. and Escherichia coli to fosfomycin
title_full In vitro susceptibility of OXA-48, NDM, VIM and IMP enzyme- producing Klebsiella spp. and Escherichia coli to fosfomycin
title_fullStr In vitro susceptibility of OXA-48, NDM, VIM and IMP enzyme- producing Klebsiella spp. and Escherichia coli to fosfomycin
title_full_unstemmed In vitro susceptibility of OXA-48, NDM, VIM and IMP enzyme- producing Klebsiella spp. and Escherichia coli to fosfomycin
title_short In vitro susceptibility of OXA-48, NDM, VIM and IMP enzyme- producing Klebsiella spp. and Escherichia coli to fosfomycin
title_sort in vitro susceptibility of oxa 48 ndm vim and imp enzyme producing klebsiella spp and escherichia coli to fosfomycin
topic fosfomycin
agar dilution
carbapenemase
url https://jidc.org/index.php/journal/article/view/12456
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