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Antimicrobial susceptibility of multidrug-resistant Gram negative bacteria to fosfomycin

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Abstract

We evaluated the antimicrobial activity of fosfomycin against a randomly selected sample of 30 Klebsiella pneumoniae, 30 Pseudomonas aeruginosa, and 30 Acinetobacter baumannii multidrug-resistant, clinical isolates from patients in a general tertiary care hospital in Athens, Greece. Standard laboratory methods were used for susceptibility testing to commonly used antibiotics and the detection of extended-spectrum-β-lactamase (ESBL) and metallo-β-lactamase (MBL) production. The minimum inhibitory concentration (MIC) of fosfomycin for each isolate was determined by the agar dilution method. All K. pneumoniae isolates were both ESBL and MBL producers; all P. aeruginosa isolates were ESBL producers. The K. pneumoniae strains had fosfomycin MICs distributed across a range of 8-64 μg/ml; MIC50 was 16 μg/ml and MIC90 32 μg/ml. The fosfomycin MICs of the P. aeruginosa strains had a distribution across a range of 4 to over 512 μg/ml; MIC50 was 32 μg/ml and MIC90 128 μg/ml. The fosfomycin MICs of the A. baumannii strains had a distribution across a range of 64 to over 512 μg/ml; MIC50 was 256 μg/ml and MIC90 more than 512 μg/ml. Although standardized fosfomycin MIC interpretative breakpoints for the species studied are lacking, the findings of our study support the idea that fosfomycin may be further investigated as one among a decreasing list of therapeutic options for the treatment of infections due to multidrug-resistant strains of, primarily, K. pneumoniae and, secondly, P. aeruginosa.

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Authors and Affiliations

  1. Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, Greece

    M. E. Falagas, D. E. Karageorgopoulos & P. I. Rafailidis

  2. Department of Medicine, Tufts University School of Medicine, Boston, MA, USA

    M. E. Falagas

  3. Department of Microbiology, Sismanoglion General Hospital, Athens, Greece

    M. D. Kanellopoulou, N. D. Skarmoutsou & E. A. Papafrangas

  4. Department of Critical Care, Attikon University Hospital, Athens, Greece

    G. Dimopoulos

Authors
  1. M. E. Falagas
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  2. M. D. Kanellopoulou
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  3. D. E. Karageorgopoulos
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  4. G. Dimopoulos
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  5. P. I. Rafailidis
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  6. N. D. Skarmoutsou
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  7. E. A. Papafrangas
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Correspondence to M. E. Falagas.

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Falagas, M.E., Kanellopoulou, M.D., Karageorgopoulos, D.E. et al. Antimicrobial susceptibility of multidrug-resistant Gram negative bacteria to fosfomycin. Eur J Clin Microbiol Infect Dis 27, 439–443 (2008). https://doi.org/10.1007/s10096-007-0456-4

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  • DOI: https://doi.org/10.1007/s10096-007-0456-4

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