J Korean Med Sci.  2014 Aug;29(8):1178-1181. 10.3346/jkms.2014.29.8.1178.

Susceptibility of Escherichia coli from Community-Acquired Urinary Tract Infection to Fosfomycin, Nitrofurantoin, and Temocillin in Korea

• Seo MR
• Kim SJ
• Kim Y
• Kim J
• Choi TY
• Kang JO
• Wie SH
• Ki M
• Cho YK
• Lim SK
• Lee JS
• Kwon KT
• Lee H
• Cheong HJ
• Park DW
• Ryu SY
• Chung MH
• Pai H

• KMID: 2129618
• DOI: http://doi.org/10.3346/jkms.2014.29.8.1178

Abstract

With increase of multi-drug resistant Escherichia coli in community-acquired urinary tract infections (CA-UTI), other treatment option with a therapeutic efficacy and a low antibiotic selective pressure is necessary. In this study, we evaluated in vitro susceptibility of E. coli isolates from CA-UTI to fosfomycin (FM), nitrofurantoin (NI), temocillin (TMO) as well as trimethoprim-sulfamethoxazole (SMX), ciprofloxacin (CIP) and cefepime (FEP). The minimal inhibitory concentrations were determined by E-test or agar dilution method according to the Clinical and Laboratory Standards Institute guidelines, using 346 E. coli collected in 12 Korean hospitals from March 2010 to February 2011. FM, NI and TMO showed an excellent susceptibility profile; FM 100% (346/346), TMO 96.8% (335/346), and NI 99.4% (344/346). Conversely, resistance rates of CIP and SMX were 22% (76/346) and 29.2% (101/349), respectively. FEP still retained an activity of 98.5%. In Korea, NI and TMO in addition to FM are a good therapeutic option for uncomplicated CA-UTI, especially for lower UTI.

Keyword

Community-Acquired Infections; Urinary Tract; Escherichia coli; Fosfomycin; Nitrofurantoin; Temocillin; Trimethoprim-Sulfamethoxazole combination; Ciprofloxacin; Cefepime; Minimal Inhibitory Concentration

MeSH Terms

Anti-Bacterial Agents/*administration & dosage
Cell Survival/*drug effects
Cephalosporins/administration & dosage
Ciprofloxacin/administration & dosage
Community-Acquired Infections/drug therapy/*microbiology
Dose-Response Relationship, Drug
Drug Combinations
Drug Resistance, Bacterial/drug effects
Escherichia coli/*drug effects
Escherichia coli Infections/drug therapy/*microbiology
Fosfomycin/administration & dosage
Humans
Nitrofurantoin/administration & dosage
Penicillins/administration & dosage
Republic of Korea
Sulfadoxine/administration & dosage
Treatment Outcome
Trimethoprim/administration & dosage
Urinary Tract Infections/diagnosis/*microbiology
Anti-Bacterial Agents
Cephalosporins
Ciprofloxacin
Drug Combinations
Fosfomycin
Nitrofurantoin
Penicillins
Sulfadoxine
Trimethoprim

Figure

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  Fig. 1 Minimal inhibitory concentration (MIC) distribution of 346 E. coli isolates to various antimicrobial agents. (A) ciprofloxacin, (B) trimethoprim-sulfamethoxazole, (C) cefepime, (D) temocillin, (E) nitrofurantoin, and (F) fosfomycin. Vertical black dotted line indicates the breakpoint of each agent.

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