Susceptibility of Escherichia coli from community-acquired urinary tract infection to fosfomycin, nitrofurantoin, and temocillin in Korea

J Korean Med Sci. 2014 Aug;29(8):1178-81. doi: 10.3346/jkms.2014.29.8.1178. Epub 2014 Jul 30.

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.

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

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Cefepime
  • Cell Survival / drug effects*
  • Cephalosporins / administration & dosage
  • Ciprofloxacin / administration & dosage
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology*
  • Dose-Response Relationship, Drug
  • Drug Combinations
  • Drug Resistance, Bacterial / drug effects
  • Escherichia coli / drug effects*
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / 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
  • Urinary Tract Infections / microbiology*

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Drug Combinations
  • Penicillins
  • temocillin
  • Fosfomycin
  • trimethoprim, sulfadoxine drug combination
  • Ciprofloxacin
  • Cefepime
  • Sulfadoxine
  • Nitrofurantoin
  • Trimethoprim