1887

Abstract

With increasing resistance to currently used antibiotics, antibiotic combinations are being resorted to. The present study deals with five children with complicated urinary tract infection (UTI) whose urine cultures grew multidrug-resistant (MDR) organisms. In all of these five cases, MDR organisms were the causative agents for UTI and the currently available antibiotics, including colistin, were ineffective, although the organisms were sensitive . In all of these cases, the isolates reverted to being susceptible to the quinolones and cephalosporins tested, namely ceftriaxone and ceftazidime. All were treated using a combination of fosfomycin with other antibiotics, since it has no interference with other classes of antibiotics. Our observations suggest that the use of a combination of fosfomycin with either a carbapenem or an aminoglycoside in a clinical setting would be a reasonable choice to treat UTIs caused by MDR organisms, especially in complicated cases that require chronic therapy.

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2020-09-03
2020-12-04
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References

  1. Wu T-H, Huang F-L, Fu L-S, Chou C-M, Chien Y-L et al. Treatment of recurrent complicated urinary tract infections in children with vesicoureteral reflux. J Microbiol Immunol Infect 2016; 49:00208–4 [CrossRef][PubMed]
    [Google Scholar]
  2. Shellikeri S, Daulton R, Sertic M, Connolly B, Hogan M et al. Pediatric percutaneous nephrostomy: a multicenter experience. J Vasc Interv Radiol 2018; 29:328–334 [CrossRef][PubMed]
    [Google Scholar]
  3. Shiraishi K, Yoshino K, Watanabe M, Matsuyama H, Tanikaze S. Risk factors for breakthrough infection in children with primary vesicoureteral reflux. J Urol 2010; 183:1527–1532 [CrossRef][PubMed]
    [Google Scholar]
  4. Bryce A, Hay AD, Lane IF, Thornton HV, Wootton M et al. Global prevalence of antibiotic resistance in paediatric urinary tract infections caused by Escherichia coli and association with routine use of antibiotics in primary care: systematic review and meta-analysis. BMJ 2016; 352:i939 [CrossRef][PubMed]
    [Google Scholar]
  5. Gaspari RJ, Dickson E, Karlowsky J, Doern G. Antibiotic resistance trends in paediatric uropathogens. Int J Antimicrob Agents 2005; 26:267–271 [CrossRef][PubMed]
    [Google Scholar]
  6. Jamil I, Zafar A, Qamar MU, Ejaz H, Akhtar J et al. Multi-drug resistant Klebsiella pneumoniae causing urinary tract infections in children in Pakistan. Afr J Microbiol Res 2014; 8:316–319
    [Google Scholar]
  7. Maraki S, Samonis G, Rafailidis PI, Vouloumanou EK, Mavromanolakis E et al. Susceptibility of urinary tract bacteria to fosfomycin. Antimicrob Agents Chemother 2009; 53:4508–4510 [CrossRef][PubMed]
    [Google Scholar]
  8. Falagas ME, Kastoris AC, Kapaskelis AM, Karageorgopoulos DE. Fosfomycin for the treatment of multidrug-resistant, including extended-spectrum beta-lactamase producing, Enterobacteriaceae infections: a systematic review. Lancet Infect Dis 2010; 10:43–50 [CrossRef][PubMed]
    [Google Scholar]
  9. Clinical Laboratory Standards Institute Performance Standards for Antimicrobial Susceptibility Testing. CLSI Supplement M100 Twenty-Ninth Edition Wayne, USA: CLSI; 2019
    [Google Scholar]
  10. European Committee on Antimicrobial Susceptibility Testing Breakpoint tables for interpretation of MICs and zone diameter, version 9.0, valid from 2019-01-01; 2019. http://www.eucast.org/ August 21, 2019
  11. Buehrle DJ, Shields RK, Clarke LG, Potoski BA, Clancy CJ et al. Carbapenem-resistant Pseudomonas aeruginosa bacteremia: risk factors for mortality and microbiologic treatment failure. Antimicrob Agents Chemother 2017; 61:e01243–16 [CrossRef][PubMed]
    [Google Scholar]
  12. Lee K, Yoon SS. Pseudomonas aeruginosa biofilm, a programmed bacterial life for fitness. J Microbiol Biotechnol 2017; 27:1053–1064 [CrossRef][PubMed]
    [Google Scholar]
  13. Falagas ME, Roussos N, Gkegkes ID, Rafailidis PI, Karageorgopoulos DE et al. Fosfomycin for the treatment of infections caused by Gram-positive cocci with advanced antimicrobial drug resistance: a review of microbiological, animal and clinical studies. Expert Opin Investig Drugs 2009; 18:921–944 [CrossRef][PubMed]
    [Google Scholar]
  14. Falagas ME, Giannopoulou KP, Kokolakis GN, Rafailidis PI. Fosfomycin: use beyond urinary tract and gastrointestinal infections. Clin Infect Dis 2008; 46:1069–1077 [CrossRef][PubMed]
    [Google Scholar]
  15. Avery LM, Sutherland CA, Nicolau DP. Prevalence of in vitro synergistic antibiotic interaction between fosfomycin and nonsusceptible antimicrobials in carbapenem-resistant Pseudomonas aeruginosa . J Med Microbiol 2019; 68:893–897 [CrossRef][PubMed]
    [Google Scholar]
  16. Okazaki M, Suzuki K, Asano N, Araki K, Shukuya N et al. Effectiveness of fosfomycin combined with other antimicrobial agents against multidrug-resistant Pseudomonas aeruginosa isolates using the efficacy time index assay. J Infect Chemother 2002; 8:37–42 [CrossRef][PubMed]
    [Google Scholar]
  17. Gopichand P, Agarwal G, Natarajan M, Mandal J, Deepanjali S et al. In vitro effect of fosfomycin on multi-drug resistant Gram-negative bacteria causing urinary tract infections. Infect Drug Resist 2019; 12:2005–2013 [CrossRef][PubMed]
    [Google Scholar]
  18. Sugathan S, Mandal J. An in vitro experimental study of the effect of fosfomycin in combination with amikacin, ciprofloxacin or meropenem on biofilm formation by multidrug-resistant urinary isolates of Escherichia coli . J Med Microbiol 2019; 68:1699–1706 [CrossRef][PubMed]
    [Google Scholar]
  19. Dijkmans AC, Zacarías NV, Burggraaf J, Mouton JW, Wilms EB et al. Fosfomycin: pharmacological, clinical and future perspectives. Antibiotics 2017; 6:24 [CrossRef][PubMed]
    [Google Scholar]
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