Role of Fosfomycin activity on ESBL producing E.coli and Klebsiella pneumoniae isolated in clinical samples at a tertiary care hospital, Sudha Medical College, Jagpura, Kota

Abstract

Background: The rise of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae has significantly complicated the management of infections in healthcare settings. With limited treatment options, the activity of alternative antibiotics like fosfomycin has garnered attention. This study aimed to assess the in vitro susceptibility of ESBL-producing E. coli and K. pneumoniae to fosfomycin in a tertiary care hospital in India.

Aim and Objective: To study the role of fosfomycin activity on ESBL Producing E. coliand

Klebsiellapneumoniaeisolated in clinical samples at a tertiary care hospital.

Methods: A total of 100 ESBL-producing isolates (E. coli n=65, K. pneumoniae n=35) were isolated from various clinical specimens, including urine, pus, sputum, Respiratory secretions, and wound swabs. ESBL production was confirmed using the combined disc method. Fosfomycin susceptibility was assessed by using the Kirby-Bauer disk diffusion method. Results were interpreted following the Clinical and Laboratory Standards Institute (CLSI) guidelines.

Results: In the present study it was observed that60 (92.3%) ESBL producing E.coli out of 65 shows susceptibility to Fosfomycin and 28 (80%) ESBL producing Klebsiella pneumoniae out of 35 shows susceptibility to Fosfomycin.  Maximum 38(58.46%) out of 65ESBL producingE. coli and maximum 12 (34.28%) out of 35 ESBL producingK. pneumoniae were isolated from urine samples.

Conclusion: Fosfomycin demonstrated high in vitro activity against ESBL-producing E. coli and K. pneumoniae, especially for urinary tract infections. This study supports the potential use of fosfomycin as an effective alternative treatment, particularly in infections where other options are limited due to antibiotic resistance. Further studies are needed to explore its clinical efficacy in combination therapy and in different infection types.