Evaluation of in vitro Susceptibility of Multi Drug Resistant Uropathogenic Escherichia Coli (UPEC) to Fosfomycin: A Comparision of Determination Methods

Background and Objective: The increasing incidence of multidrug - resistant (MDR) pathogenic bacteria, both in hospital and community settings, causing Urinary tract infection (UTI) is inducing clinicians to reconsider old antibiotics, such as fosfomycin, to overcome the difficulties posed by these microorganisms. Keeping in the view of above fact, the present study was carried out to know the susceptibility pattern of Fosfomycin against multi drug resistant uropathogenic Escherichia coli (MDR UPEC) by different methods. Materials and Methods: A cross sectional study was conducted for 4 months from july to october 2021 by using conventional methods and pathogenic bacteria were isolated from urine samples followed by antibiotic susceptibility testing MDR UPEC were tested against fosfomycin using the Kirby - Bauer diffusion method and E - test and agar dilution methods according to CLSI recommendations taking agar dilution as gold standard. Results: A total of 652 urine samples were processed, among which 278 number of samples showed significant bacterial growth. From these isolates, 71 (25.5%) were Escherichia coli. Clinical isolates of Escherichia coli showing MDR were tested against fosfomycin using disk diffusion, E - test and agar dilution. Disk diffusion and E - test showed 100% susceptibility to Fosfomycin where as agar dilution test detected 90% susceptibility. Conclusion: Fosfomycin showed very good activity against MDR UPEC. It has the potential to emerge as a promising alternative oral agent for uncomplicated UTI over prolonged period of time.