Fosfomycin susceptibility of uropathogens resistant to antibiotics used in peri-operative prophylaxis of urinary tract infection among patients after urogynaecological surgery.

INTRODUCTION AND OBJECTIVE: Antibiotic prophylaxis is one of the methods for preventing urinary tract infection (UTI) after urogynecological surgeries. Fosfomycin trometamol (FT) has emerged as a promising option in cases involving multidrug-resistant (MDR) pathogens in which previous antibiotics have failed. The aim of the study is to analyze the susceptibility to FT of common uropathogens, resistant to other antibiotics in patients with post-operative UTI.

MATERIAL AND METHODS: A retrospective study of susceptibility and resistance to commonly used antibiotics was performed by examining the results of urine analysis (n=173) of women with UTI after urogynaecological surgeries. The agar dilution method with glucose-6-phosphate for MIC determination were used for resistance and susceptibility testing in positive urine cultures (≥105 colony forming units (CFUs)/mL). Resistance to commonly used antibiotics was analyzed in comparison to resistance to FT.

RESULTS: In 173 results of urine analysis, 95.95% of the total isolates were found to be susceptible to FT. Among isolates resistant to amoxicillin/clavulanic acid, ampicillin, cephalexin, trimethoprim/sulfamethoxazole, ciprofloxacin, nitrofurantoin; respectively, 80.00%, 94.44%, 77.78%, 96.30%, 90.91%, and 84.38% were susceptible to FT.

CONCLUSIONS: Peri-operative prophylaxis of UTI with FT is a promising alternative to classic antibiotics due to the high susceptibility of uropathogens, including MDR isolates. The decision about the prophylaxis method should be made based on the epidemiological updated recommendations. The study shows the need for ongoing observation of antibiotic resistance patterns in order to guide prophylaxis recommendations, especially in the era of MDR pathogens.