Fosfomycin, from susceptibility to resistance: impact of the new guidelines on breakpoints.

Fosfomycin, from susceptibility to resistance: impact of the new guidelines on breakpoints. Med Mal Infect. 2020 Jul 14;: Authors: Farfour E, Degand N, Riverain E, Fihman V, Le Brun C, Péan-de-Ponfilly G, Muggeo A, Jousset A, Piau C, Lesprit P Abstract The fosfomycin breakpoint using the disc diffusion method (DDM) changed in the 2019 CA-SFM/EUCAST guidelines v2 (24 mm versus 19 mm). We assessed its impact on categorization of Enterobacterales recovered from urine samples in emergency departments. A total of 7,749 and 2,348 strains were tested using the DDM and the broth microdilution method (BMD), respectively. The DDM with the 19-mm breakpoint was in accordance with the BMD. Using the 24-mm breakpoint, the overall rate of fosfomycin resistance in Enterobacterales increased by three-fold (5.6% vs 18.1%, p<0.01) and reached 2.8% and 86.5% in E. coli and K. pneumoniae, respectively. French guidelines for the management of community-acquired UTI remain appropriate. The accuracy of the methods for routine fosfomycin susceptibility testing should be assessed. The role of fosfomycin in the treatment of documented CA-UTI due to Enterobacterales other than E. coli should be evaluated considering its rate of resistance and recent data reporting low accuracy. PMID: 32679342 [PubMed - as supplied by publisher]
Source: Medecine et Maladies Infectieuses - Category: Infectious Diseases Tags: Med Mal Infect Source Type: research