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Susceptibility of carbapenem-resistant Klebsiella pneumoniae in urinary tract infections: clinical efficacy of fosfomycin - PubMed

5 days ago
  • #Urinary Tract Infections
  • #Klebsiella pneumoniae
  • #Antibiotic Resistance
  • Study evaluates susceptibility of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) in urinary tract infections (UTIs) to oral antibiotics and ceftazidime-avibactam.
  • Retrospective analysis of 179 patients with CR-Kp UTIs from March 2016 to October 2022, assessing antibiotic susceptibility and treatment outcomes.
  • Fosfomycin tromethamol showed 33.7% susceptibility, nitrofurantoin 7.7%, and co-trimoxazole (TMP-SMX) 11.1%. All strains were resistant to ciprofloxacin.
  • Post-2020, TMP-SMX susceptibility increased significantly from 4.9% to 24.1% (p = 0.0001).
  • Ceftazidime-avibactam sensitivity was 59% among 22 tested isolates.
  • One-month mortality (OMM) rate was 37.4% (67/179).
  • Fosfomycin sodium-including therapy regimens (FSITR) achieved microbiological eradication in 87.5% (7/8) of cases, with OMM at 44.4% (4/9).
  • Study suggests fosfomycin-including regimens may be a salvage treatment for CR-Kp UTIs, but highlights limitations due to its retrospective, single-center design.