Evaluating the Potential of Nitrofurantoin and Fosfomycin for E. coli UTIs: A Susceptibility Study
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Keywords

E. coli
Fosfomycin
Nitrofurantoin
Susceptibility
Urinary isolates

DOI

10.26689/jcnr.v8i6.7063

Submitted : 2024-06-18
Accepted : 2024-07-03
Published : 2024-07-18

Abstract

This study was designed to find the susceptibility of Nitrofurantoin and Fosfomycin among urinary isolates of Escherichia. coli. Four hundred (400) urine samples were collected for susceptibility of nitrofurantoin and fosfomycin among urinary isolates of E. coli. All indoor and outdoor patients’ urinary samples yielded growth of E. coli. Mid-stream urine specimens were inoculated on blood agar and CLED agar and incubated at 35 ± 2 ℃. Growth was observed, and Escherichia coli was identified by Gram staining, Catalase, Motility test and API 20E (Bio murex) as per standard procedure. Antimicrobial susceptibility testing of isolates for nitrofurantoin and fosfomycin was carried out by the modified Kirby-Bauer disc diffusion method according to CLSI guidelines ATCC 25922. E. coli was used as a quality control strain. A total of 400 samples were tested susceptibility of nitrofurantoin and fosfomycin among urinary isolates of E. coli during this period. A total of 400 samples yielded the growth of E. coli, out of which 178 (44.5%) were male and 222 (55.5%) were female samples. Among males, 18 (10%) were tolerant to nitrofurantoin, and 2 (1.1%) were tolerant to fosfomycin. Among females, 9 (4.09%) were susceptible to nitrofurantoin while 6 (2.72%) were susceptible to fosfomycin. Among age groups below 45 years old, 6 (4.76%) were tolerant to nitrofurantoin, and 2 (1.58%) were sensitive to fosfomycin. Between 46–66 years old, 4 (2.81%) were sensitive to nitrofurantoin, and 3 (2.11%) were sensitive to fosfomycin. Between 67–90 years old, 17 (12.87%) were sensitive to nitrofurantoin, and 4 (3.03%) were tolerant to fosfomycin. Fosfomycin and nitrofurantoin showed good susceptibility in urinary isolates of E. coli and can be used empirically in our setup.

References

Alziadi R, Attar EJ, 2023, Detection of Virulence Genes Stx1, Stx2, eae A and hly A in E. coli Isolated from Local Minced Meat. In IOP Conference Series: Earth and Environmental Science, 1225(1): 12037.

Zhang Y, Tan P, Zhao Y, et al., 2022, Enterotoxigenic Escherichia coli: Intestinal Pathogenesis Mechanisms and Colonization Resistance by Gut Microbiota. Gut Microbes, 14(1): 2055943.

Chen C, Yue Y, He Z, et al., 2023, Lactobacillus gasseri Relieves Diarrhea Caused by Enterotoxin-producing Escherichia coli Through Inflammation Modulation and Gut Microbiota Regulation. Food Bioscience, 56(1): 103186.

Abdulabbas HS, Al-Khafaji N, Abed SY, et al., 2023, Phylotypes and Pathotypes of Diarrheagenic Escherichia coli of Gastroenteritis. Escherichia coli Infections: An Update, 1–17.

Ma M, 2023, Detection of Tetracycline and Ampicillin Resistant E. coli and Salmonella Species from Hospital Wastewater. Bangladesh Veterinarian, 40(1–2): 16–24.

Mattioni Marchetti V, Hrabak J, Bitar I, 2023, Fosfomycin Resistance Mechanisms in Enterobacterales: An Increasing Threat. Frontiers in Cellular and Infection Microbiology, 4(1)3: 1178547.

Wang T, Wu G, Wang J, et al., 2020, Comparison of Single-dose Fosfomycin Tromethamine and Other Antibiotics for Lower Uncomplicated Urinary Tract Infection in Women and Asymptomatic Bacteriuria in Pregnant Women: A Systematic Review and Meta-analysis. International Journal of Antimicrobial Agents, 56(1): 106018.

Bunduki GK, Heinz E, Phiri VS, et al., 2021, Virulence Factors and Antimicrobial Resistance of Uropathogenic Escherichia coli (UPEC) Isolated from Urinary Tract Infections: A Systematic Review and Meta-analysis. BMC Infectious Diseases, 21(1), 1–13.

Riaz M, Jadoon S, Khalid H, et al., 2024, The Abundance of ESBL-expressing, Multidrug-resistant Escherichia coli in Pakistani Patients with Urinary Tract Infections. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 55(3): 1347–1356.

Asghar F, Muhammad S, Anjum AA, et al., 2023, Multi-drug Resistance Pattern of Bacterial Isolates from Urinary Tract Infection. Pakistan Journal of Pharmaceutical Sciences, 36(4): 1107–1112.

Ghosh RK, Paul P, Ali MH, et al., 2023, Prevalence and Resistant Patterns of Multidrug-resistant Urinary Tract Infection Caused by Escherichia coli Among Patients Admitted to a Teaching Hospital. International Journal of Research in Medical Sciences, 11(9): 3228.

Skali H, Lazrak FZ, Hanchi AL, 2022, Urinary Tract Infections in Urology: Highlight on the Epidemiological and Bacteriological Profile. Journal of Microbiology & Experimentation, 10(1): 18–22.

Paykoc EI, Turkyilmaz S, 2018, Investigation of P Fimbriae Presence in Escherichia coli Strains Isolated from Urine Samples in Human, and Their Antibacterial Resistance. Jundishapur Journal of Microbiology, 11(9): e66119.

Sabir S, Anjum AA, Ijaz T, et al., 2014, Isolation and Antibiotic Susceptibility of E. coli from Urinary Tract Infections in a Tertiary Care Hospital. Pakistan Journal of Medical Sciences, 30(2): 389.

Huttner A, Verhaegh EM, Harbarth S, et al., 2015, Nitrofurantoin Revisited: A Systematic Review and Meta-analysis of Controlled Trials. Journal of Antimicrobial Chemotherapy, 70(9): 2456–2464.

Lai B, Zheng B, Li Y, et al., 2014, In vitro Susceptibility of Escherichia coli Strains Isolated from Urine Samples Obtained in Mainland China to Fosfomycin Trometamol and Other Antibiotics: A 9-year Surveillance Study (2004–2012). BMC Infectious Diseases, 14(66): 1–4.

Seo MR, Kim SJ, Kim Y, et al., 2014, Susceptibility of Escherichia coli from Community-acquired Urinary Tract Infection to Fosfomycin, Nitrofurantoin, and Temocillin in Korea. Journal of Korean Medical Science, 29(8): 1178.

Singh S, Kumar S, Sandhu R, et al., 2015, Prevalence of Drug Resistance in ESBL Producing Escherichia coli Causing UTI in Rural Tertiary Care Hospital from Haryana, India. International Journal of Basic and Applied Medical Sciences, 5(3): 1–7.