Fosfomycin, from susceptibility to resistance: Impact of the new guidelines on breakpoints.
Med Mal Infect
; 50(7): 611-616, 2020 Oct.
Article
em En
| MEDLINE
| ID: mdl-32679342
ABSTRACT
The fosfomycin breakpoint using the disc diffusion method (DDM) changed in the 2019 CA-SFM/EUCAST guidelines v2 (24mm versus 19mm). We assessed its impact on categorization of Enterobacterales recovered from urine samples in emergency departments. A total of 7749 and 2348 strains were tested using the DDM and the broth microdilution method (BMD), respectively. The DDM with the 19-mm breakpoint was in accordance with the BMD. Using the 24-mm breakpoint, the overall rate of fosfomycin resistance in Enterobacterales increased by three-fold (5.6% vs 18.1%, P<0.01) and reached 2.8% and 86.5% in E. coli and K. pneumoniae, respectively. French guidelines for the management of community-acquired UTI remain appropriate. The accuracy of the methods for routine fosfomycin susceptibility testing should be assessed. The role of fosfomycin in the treatment of documented CA-UTI due to Enterobacterales other than E. coli should be evaluated considering its rate of resistance and recent data reporting low accuracy.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Bactérias
/
Farmacorresistência Bacteriana
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Fosfomicina
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Antibacterianos
Tipo de estudo:
Guideline
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article