1592. Fosfomycin Minimum Inhibitory Concentrations in Multi-Drug Resistant Organisms of Uncomplicated Urinary Tract Infections
Session: Poster Abstract Session: Multidrug-Resistant Gram Negative Rods
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Fosfomycin Poster v4 PS[1].png (425.5 kB)
  • Background:

    An increasing number of urinary tract infections due to multi-drug resistant (MDR) bacteria have been observed in East Orange General Hospital located in East Orange, NJ and in St. Mary’s Hospital located in Passaic, NJ, which have left limited options for treatment. Fosfomycin has been reported to retain in-vitro activity against some MDR organisms. Over the course of 4 months, the minimum inhibitory concentration (MIC) of fosfomycin for various organisms has been recorded via E test (BioMerieux, Durham, NC). A summary of fosfomycin activity for 21 MDR isolates has been reported.

    Methods:

    All urine samples were tested against standard anti-microbial agents on the Vitek-2 panel (BioMerieux, Durham, NC). Fosfomycin E tests were utilized on the MDR bacterial isolates present in urine samples to identify their susceptibility if the isolate was reported to be MDR. The results were prospectively reviewed between December 2012-March 2013 and then tabulated. The dates of isolation, source site, and MICs for fosfomycin were recorded for each organism.

    Results:

    21 isolates were included in the analysis. 11 isolates were Klebsiella pneumoniae (KP), 8 were Escherichia coli (EC), 2 were Enterocococcus faecalis (ES) 8 of the 11 KP isolates were sensitive to tigecycline and 2 of the 11 KP isolates were sensitive to gentamicin. Out of the 8 EC isolates 5 were sensitive to tigecycline, 5 were sensitive to nitrofurantoin, and 6 were sensitive to gentamicin. An MIC of <64 ng/mL suggests the organism is susceptible to fosfomycin. 10/11 KP isolates, 8/8 EC, and 1 ES had MICs less than 64 ng/mL.

    Conclusion: In this study, fosfomycin demonstrated in vitro activity against several MDR organisms and may offer a viable alternative for treatment of highly MDR organisms isolated from the urinary tract. Additional studies are warranted to explore the clinical impact of fosfomycin in this patient subset.

    Kevin Mcdonough, BS, PharmD , MPA, Pharmacy, East Orange General Hospital, East Orange, NJ; Pharmacy, Cardinal Health. Pharm. Services, East Orange, NJ, Bhavna Desai, BS, MT(ASCP), CIC, St Mary's Hospital, Passaic, NJ, Gerry Somera, BSMP, Lab, East Orange General Hospital, East Orange, NJ and Diana Finkel, DO, St. Mary's Hospital, Passaic, NJ

    Disclosures:

    K. Mcdonough, None

    B. Desai, None

    G. Somera, None

    D. Finkel, None

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