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

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.