In vitro activity of fosfomycin against uropathogen multi-drug resistant (MDR) Pseudomonas aeruginosa and Acinetobacter baumannii

MS Rasool, M Ajaz, F Siddiqui, SA Rasool, S Hafiz



Urinary tract infections caused by multidrug resistant Gram negative bacilli constitute a major global healthcare problem. Fosfomycin is considered the best treatment option for such infections. Urine samples were collected and cultured in a tertiary care hospital (Urology). Identification of these uropathogens and their antibiotic sensitivity screening were performed according to CLSI guidelines. Urine samples (n=436) were selected in which Ps. aeruginosa and Acinetobacter baumannii were
found to be the significant pathogens and treated-exposed to fosfomycin. Sixty six (15%) were identified as Acinetobacter baumanniiPs. aeruginosa n=370(85%). Forty four percent of all Ps. aeruginosa were found to be multidrug resistant while 48.5% of the Acinetobacter baumannii strains were found multidrug resistant. Polymyxin B was found to be the most effective drug (100%) against all uropathogens and fosfomycin was found effective against 73% of the multidrug resistant Acinetobacter baumannii isolates and 70% of the multidrug resistant Pseudomonas aeruginosa strains. It may be concluded that  antimicrobial  activity (in vitro) of fosfomycin, especially against MDR uropathogens, is very effective.

KeywordsFosfomycin, Multidrug resistant Gram negative bacilli, Urinary tract infections, Ps.  aeruginosa, Acinetobacter baumannii



Les infections des voies urinaires causées par les bacilles de multi résistants Gram négatifs, constituent un problème majeur de sante mondiale. Fosfomycine est considéré comme la meilleure option de traitement pour telles infections. Les échantillons d’urine ont été recueillis et cultives dans un hôpital de soins tertiaires. Identification de ces uropathogènes et programmation de leur sensibilité aux  antibiotiques ont été réalisés selon les directives (CLSI). Les échantillons d’urine (n = 436) ont été choisis dans laquelle Ps. aeruginosa et Acinetobacter baumannii se sont trouves être l’agent pathogène important et traités – exposés a Fosfomycine. Soixante – six (15%) ont été identifies comme  Acinetobacter baumannii, Ps. aeruginosa = 370 (85%). Quarante – quatre pourcent de tous les Ps. aeruginosa se sont trouvés être multi résistants et 48,5% des souches Acinetobacter baumannii se
sont trouves multi résistants. Polymyxine B a été trouvé d’être le médicament le plus efficace (100%) contre tous les uropathogènes et Fosfomycine a été trouvé efficace contre 73% des isolats de multi résistants Acinetobacter baumannii et 70% des souches de multi résistants Pseudomonas aeruginosa. On peut conclure que l’activité antimicrobienne (in vitro) de Fosfomycine est très efficace, particulièrement contre les uropathogenes MDR.

Mots – clés : Fosfomycine, les bacilles de Multi résistants Gram négatifs, les infections des voies urinaires, Ps. aeruginosa, Acinetobacter baumannii.

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In vitro activity of fosfomycin against uropathogen multi-drug resistant (MDR) Pseudomonas aeruginosa and Acinetobacter baumannii


Epidemiological Study Of Asymptomatic Bacteriuria Among Nursery School Children In Ahvaz, Iran

M Jalali, T Asteraki, E Emami-Moghadam, E Kalantar



This study was undertaken to determine the prevalence of asymptomatic bateriuria in preschool children of different age and sex groups and to isolate the organisms responsible for asymptomatic bacteriuria and determine their antimicrobial susceptibility pattern. A total of 475 children from 17 nurseries in Ahvaz city, Iran were screened by collecting mid-stream urine samples for the presence of causative organisms. Asymptomatic bacteriuria was observed in 16 cases (3.36%). The isolated pathogens included Escherichia coli (50 %), Proteus mirabilis (25 %) and coagulase negative staphylococcus (25 %). The antibiograms indicated that Gentamicin (100 %), Nalidixic acid (100 %), Amikacin (75%), Kanamycin (75 %), Nitrofurantoin ( 62.5 %), Tobramycin ( 62.5 %), Tetracycline ( 50 %) and Chloramphenicol (37.5%), were in that order the most effective of the antibiotics tested against E. coli isolates. Proteus mirabilis showed 100% sensitivity to Amikacin, Gentamicin, Kanamycin, Nalidixic acid and Tobramycin followed by Nitrofurantoin (75%), Cephalotin (50%) and Chloramphenicol (50%). Similarly, antibiogram of coagulase negative staphylococcus showed 75% sensitivity to both Nalidixic acid and Kanamycin. This result indicated a significant rise in the frequency of Escherichia coli in asymptomatic bacteriuria.
Key words: Asymptomatic bacteriuria, children, urinary tract infections

Afr. J. Clin. Exper. Microbiol. 2005; 6(2): 159-161


AO Oyagade, SI Smith, O Famurewa



Microbiological culture examination of urine samples from 502 pregnant women attending antenatal clinic resulted in the isolation of seven genera of bacterial species. They were Staphylococcus aureus 16 (21.3%), Escherichia coli 12 (16.0%), Staphylococcus spp. 11(14.7%), Klebsiella spp. 8 (10.7%), Pseudomonas aeruginosa 7 (9.8%), Streptococcus faecalis 6 (8.0%), and Citrobacter spp. 1 (1.3%). Asymptomatic significant bacteriuria occurred in 16 (12.22%), pyuria in 10 (2.0%) while significant bacteriuria with pyuria occurred in 1(0.2%). The antibiogram indicated that ofloxacin, ciprofloxacin and nalidixic acid were in that order the most effective of the antibiotics tested. All isolates showed multiple resistance to most of the antibiotics tested. Plasmid DNA was detected in Ps. aeruginosa and E. coli with an estimated molecular weight of between 4.5 and 6.5 kb. The result indicated a significant rise in the frequency of S. aureus in asymptomatic bacteriuria.

Key Words: Asymptomatic bacteriuria, urinary tract infections, pregnant women

African Journal Of Clinical And Experimental Microbiology Jan 2004 Vol.5 No.1 64-77