High Rates of Fosfomycin Resistance in Gram-Negative Urinary Isolates from Israel

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Updated: Jan 29, 2026

Isolation and Chemical Characterization of Lipid A from Gram-negative Bacteria
12:57

Isolation and Chemical Characterization of Lipid A from Gram-negative Bacteria

Published on: September 16, 2013

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Avi Peretz1,2, Basel Naamneh3, Linda Tkhawkho2

  • 11 Clinical Microbiology Laboratory, The Baruch Padeh Medical Center Poriya, Tiberias, Israel.

Microbial Drug Resistance (Larchmont, N.Y.)
|February 7, 2019
PubMed
Abstract

Insights

Antimicrobial resistance is rising globally. Fosfomycin nonsusceptibility in urinary tract infections (UTIs) is increasing, particularly in elderly patients, hospital-acquired UTIs, and with extended-spectrum beta-lactamase (ESBL) positive isolates.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Rising antimicrobial resistance poses a global health threat.
  • Urinary tract infection (UTI) isolates often exhibit resistance to oral antibiotics, requiring intravenous therapy.
  • Fosfomycin, a broad-spectrum antibiotic, is a first-line treatment for cystitis due to high urinary concentrations.

Purpose of the Study:

  • To investigate fosfomycin susceptibility in Gram-negative urinary isolates.
  • To identify demographic and bacterial factors associated with fosfomycin nonsusceptibility.

Main Methods:

  • Retrospective study of 1503 Gram-negative urinary isolates from Padeh-Poriya Medical Center.
  • Antimicrobial susceptibility testing using VITEK2 system and disk diffusion.
  • Analysis of demographic and clinical data from patient electronic records.

Main Results:

  • 73.1% of isolates were susceptible to fosfomycin.
  • Fosfomycin nonsusceptibility increased from 20.7% in 2015 to 30.9% in 2016.
  • Nonsusceptibility was significantly correlated with older patient age, hospital-acquired UTI, and extended-spectrum beta-lactamase (ESBL) positivity.

Conclusions:

  • Fosfomycin nonsusceptibility in urinary isolates is a growing concern.
  • Nonsusceptibility is more prevalent in elderly patients, nosocomial UTIs, and ESBL-positive isolates.
  • This trend highlights the need for ongoing surveillance and antimicrobial stewardship.
Keywords:
ESBLantimicrobial resistancefosfomycinurinary tract infection

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