β-lactamase Characterization of Baseline Pseudomonas aeruginosa (PSA) from Five Ceftazidime-avibactam (CAZ-AVI) Phase 3 Clinical Trials
Abstract
Background. Fosfomycin (FOS) is active against Escherichia coli and approved for treatment of uncomplicated urinary tract infection (UTI). FOS-resistant E. coli mutants can easily be selected in vitro , but FOS resistance is not widespread among clinical isolates of E. coli to date. It is not known whether treatment with FOS leads to development of FOS resistance in commensal E. coli . Methods. Patients who were administered FOS were prospectively identified at a teaching hospital in Pennsylvania between January 2016 and February 2017. Weekly perirectal swabs from these patients that were routinely collected for screening of VRE colonization were retrieved. The swabs were first suspended in nutrient broth for enrichment for 4 hours, followed by overnight culture on EMB agar plates with or without 10 µg/ml of FOS and 25 µg/ml glucose-6-phosphate. The limit of detection was 10 CFU/swab. Results. During the 12-month study period, 552 doses of FOS were given to 505 patients. We recovered and tested 501 swabs from 283 of these patients. Among them, 48 patients had swabs collected before and after their FOS dose. Colonies consistent with E. coli grew in 106 of 501 swabs tested, 44 of which were collected after FOS administration. However, none of them grew E. coli with reduced FOS susceptibility. suggests that either intestinal exposure to oral FOS does not facilitate generation of FOS resistance among commensal E. coli , or such FOS-resistant mutants may be generated but are…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 505 participants or records.
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