In vitro inhibitory effect of fosfomycin trometamol and cefoperazone sulbactam on Enterobacteriaceae producing ESBL
Abstract
Introduction: Urinary tract infections represent a significant challenge in public health, particularly due to the limited availability of antimicrobial agents to treat resistant microorganisms, such as extended-spectrum beta-lactamase producing enterobacteria.
Objective: To evaluate the in vitro activity of fosfomycin and cefoperazone/sulbactam against ESBL strains isolated from urinary tract infections and asymptomatic bacteriuria at the Lambayeque Regional Hospital from 2018 to 2020.
Methods: An observational descriptive study was conducted, analyzing 268 ESBL strains divided into groups based on their origin, stemming from both urinary tract infections (UTIs) and cases of asymptomatic bacteriuria. The presence of ESBL was confirmed using the Jarlier test, and identification was performed using the Vitek 2 system. Susceptibility to cefoperazone/sulbactam and fosfomycin trometamol was assessed using the Kirby-Bauer method.
Results: 95.5% of the isolated bacteria were ESBL-producing E. coli. According to CLSI criteria, 99.3% were susceptible to fosfomycin, while under EUCAST criteria, susceptibility was 91.8%. The susceptibility to cefoperazone/sulbactam was 91.4%. The average inhibition zone diameters for fosfomycin and cefoperazone/sulbactam were 25.14 mm and 22.5 mm, respectively.
Conclusions: Both cefoperazone/sulbactam and fosfomycin demonstrated a high in vitro inhibitory effect against ESBL-producing bacteria, making them excellent candidates for future clinical studies. The observed susceptibility in asymptomatic bacteriuria cases indicates that there is no silent reservoir of resistance to these drugs that could rapidly increase with more widespread use.
DeCS: DISEASE SUSCEPTIBILITY; URINARY TRACT INFECTIONS; BETA-LACTAM RESISTANCE; BACTERIURIA; ESCHERICHIA COLI.
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References
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