With the increasing emergence of drug resistance in enterococci, there have been very limited data on the efficacy of orally available nitrofurantoin and fosfomycin on enterococci causing urinary tract infections (UTIs), particularly for multidrug-resistant (MDR) strains. This study aimed to determine the in vitro effectiveness of these two drugs against the MDR enterococci. A total of 514 phenotypically and genotypically confirmed isolates of enterococci (239, 46.5% Enterococcus faecalis and 275, 53.5% Enterococcus faecium) showed E. faecalis as significantly more resistant (p < 0.05) to ciprofloxacin and high strength gentamicin. Vancomycin resistance was seen in 37 (7.2%) isolates. Of these, 114 (22.18%) isolates (51, 44.73% E. faecalis and 63, 55.26% E. faecium) were MDR. Nitrofurantoin minimum inhibitory concentrations (MICs) for the MDR enterococci varied from 1 to 128 μg/mL (MIC₅₀ 8 μg/mL, MIC₉₀ 64 μg/mL for E. faecalis), while fosfomycin MICs for the MDR E. faecalis, including vancomycin resistant enterococci (VRE) were in susceptible range (≤64 μg/mL, MIC₅₀ 8 μg/mL, MIC₉₀ 16 μg/mL). An efficacy ratio of ≥8 for nitrofurantoin was observed in the 39 (76.5%) MDR E. faecalis and 44 (69.8%) MDR E. faecium isolates as against the 50 (98%) E. faecalis isolates for fosfomycin. Although nitrofurantoin has been widely prescribed for the treatment of UTIs for the past several years, it was still found to be active in vitro against the urinary isolates of MDR enterococci, including VRE. As for fosfomycin, it holds robust potential to be used against the urinary MDR enterococci and VRE (E. faecalis).

中文翻译：

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呋喃妥因和磷霉素对印度 10 年内耐多药肠球菌门诊尿分离株的敏感性

随着肠球菌耐药性的增加，关于口服呋喃妥因和磷霉素对引起尿路感染 (UTI) 的肠球菌，特别是多重耐药 (MDR) 菌株的疗效的数据非常有限。本研究旨在确定这两种药物对 MDR 肠球菌的体外有效性。共有 514 株经表型和基因型证实的肠球菌分离株（239 株，46.5%粪肠球菌和 275株，53.5%粪肠球菌）显示粪肠球菌的耐药性明显更高（p < 0.05) 到环丙沙星和高强度庆大霉素。在 37 个 (7.2%) 分离株中观察到万古霉素耐药性。其中，114 个 (22.18%) 分离株（51 个，44.73% 的粪肠球菌和 63 个，55.26% 的粪肠球菌）是耐多药的。呋喃妥因对 MDR 肠球菌的最小抑制浓度 (MIC) 为 1 至 128 μg/mL（MIC ₅₀ 8 μg/mL，MIC ₉₀ 64 μg/mL 对粪肠球菌），而磷霉素对 MDR粪肠球菌的MICs不等，包括耐万古霉素肠球菌（VRE）在敏感范围内（≤64 μg/mL，MIC ₅₀ 8 μg/mL，MIC ₉₀ 16 μg/mL）。在 39 例（76.5%）MDR粪肠球菌中观察到呋喃妥因的疗效比≥8和44（69.8％）MDR屎肠球菌分离物作为对50（98％）粪肠球菌分离物为磷霉素。尽管在过去几年中呋喃妥因已被广泛用于治疗 UTI，但在体外仍发现它对MDR 肠球菌的尿分离物（包括 VRE）具有活性。至于磷霉素，它具有强大的潜力，可用于对抗尿耐多药肠球菌和 VRE（粪肠球菌）。