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Abstract

SUSCEPTIBILITY OF MULTIDRUG RESISTANT GRAM-NEGATIVE BACTERIA TO FOSFOMYCIN

B. N. Vasudha Kowshik* and Sumana M. N.

ABSTRACT

The troubling rise in antibiotic resistance rates recorded for different pathogens led to the use of alternative treatment policies. The reassessment of older antibiotics is now an interesting choice, given the fairly restricted supply of new antimicrobial drugs.[1] Fosfomycin, a bactericidal analog of phosphoenolpyruvate that has previously been employed as an oral treatment for uncomplicated urinary tract infection, has recently raised interest among physicians worldwide.[3] In general, the advanced resistance identified in Gram-negative bacteria indicates that in patients with highly resistant microbial infections, fosfomycin may be an effective treatment of choice. This study focuses on the possibility of expanding the use of fosfomycin beyond urinary tract infections and against Gram-negative multidrug-resistant bacteria.[4] Objectives:- To evaluate the in-vitro activity of fosfomycin against multi drug resistant gram negative Bacterial isolates. Methodology:- The study was conducted prospectively in the Department of Microbiology of a tertiary care hospital from January 2019 to December 2019. A total of 100 multi-drug resistant isolates of E-coli, Klebsiella pneumonia, Acinetobacter baumannii, Enterobacter cloacae were collected from the patients admitted to a tertiary care hospital Mysuru, Karnataka. These isolates were subjected to fosfomycin susceptibility testing methods by disk diffusion & agar dilution method & the two methods were compared. Result:- 100 multidrug resistant gram-negative isolates were tested for susceptibility to fosfomycin. Of the 100 isolates of multidrug resistance(by disk diffusion & vitek 2 identification) there were 27 isolates from PUS , 16 isolates from SPUTUM, 29 isolates from ENDOTRACHEAL ASPIRATE, 17 isolates from URINE, 8 isolates from BLOOD, 1 isolate from URINARY CATHTER TUBE, 1 isolate from THROAT SWAB, 1 isolate from BILE. In the present study, we obtained fosfomycin susceptibilitiy 73 were sensitive out of 100 isolates, 8 were intermediate & 19 were resistant. Among 100 isolates 80.39% (41 out of 51) in K.pneumoniae, 60.52% (23 out of 38) A.baumannii, 88.88% (8 out of 9) in E.coli & 100% (1 out of 1) in A.lowfii were sensitive to fosfomycin. Conclusion:- Fosfomycin is effective against multidrug resistant gram negative bacteria.

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