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 tractinfections (CA-UTI), other treatment option with a therapeutic efficacy and a low antibioticselective pressure is necessary. In this study, we evaluated in vitro susceptibility of E. coliisolates from CA-UTI to fosfomycin (FM), nitrofurantoin (NI), temocillin (TMO) as well astrimethoprim-sulfamethoxazole (SMX), ciprofloxacin (CIP) and cefepime (FEP). Theminimal inhibitory concentrations were determined by E-test or agar dilution methodaccording to the Clinical and Laboratory Standards Institute guidelines, using 346 E. colicollected in 12 Korean hospitals from March 2010 to February 2011. FM, NI and TMOshowed 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 andTMO in addition to FM are a good therapeutic option for uncomplicated CA-UTI, especiallyfor lower UTI.