This study evaluates whether the rapid fosfomycin resistance (fosfomycin NP) method can be used for detecting fosfomycin resistance in routine laboratory work. Results from the disk diffusion and rapid fosfomycin NP methods were compared with the reference agar dilution method for Escherichia coli and Klebsiella spp. strains isolated from urinary tract infections.

The study included 57 E. coli and 48 Klebsiella spp. isolates from urinary tract infections. The reference agar dilution and disk diffusion methods were performed in accordance with EUCAST recommendations, and the results were evaluated according to EUCAST V.10.0. The method developed by Nordmann et al. was used for rapid detection of fosfomycin resistance (Nordmann, P., Poirel, L., Mueller, L., 2019. Rapid Detection of Fosfomycin Resistance in Escherichia coli. J Clin Microbiol. 57(1), e01531–18. doi:https://doi.org/10.1128/JCM.01531-18). The acceptable categorical agreement (CA ≥ 90%) and the rates of major error (ME <3%) and very major error (VME < 3%) of the two methods were compared with the reference method according to the criteria of ISO 20776-1.

Fosfomycin resistance was detected in 15.8% of E. coli and 75% of Klebsiella spp. isolates using the reference method. Disk diffusion method showed CA 89.5%, ME 12.5% in E. coli isolates, and CA 75%, ME 100% in Klebsiella spp. isolates. No VME was detected in both methods. The rapid fosfomycin NP method resulted in CA 96.4%, ME 0.0%, VME 22.2% in E. coli isolates, and CA 77.3%, ME 81.8%, and VME 3% in Klebsiella spp. isolates.

We believe the results from both of disk diffusion assay and rapid fosfomycin NP for the E. coli and Klebsiella spp. isolates are incompatible with the reference method and should not be used as an alternative to the agar dilution method.

本研究评估快速磷霉素耐药（fosfomycin NP）方法是否可用于检测常规实验室工作中的磷霉素耐药性。将圆盘扩散法和快速磷霉素 NP 方法的结果与大肠杆菌和克雷伯氏菌属的参考琼脂稀释方法进行比较。从尿路感染中分离出的菌株。

该研究包括 57 种大肠杆菌和 48种克雷伯氏菌。与尿路感染分离。参照琼脂稀释和圆片扩散方法按照 EUCAST 建议进行，结果按照 EUCAST V.10.0 进行评估。Nordmann 等人开发的方法。用于磷霉素耐药性的快速检测（Nordmann, P., Poirel, L., Mueller, L., 2019. Rapid Detection of Fosfomycin Resistance in Escherichia coli . J Clin Microbiol. 57(1), e01531–18. doi: https://doi.org/10.1128/JCM.01531-18）。根据 ISO 20776 的标准，将两种方法的可接受分类一致性（CA ≥ 90%）和主要错误率（ME <3%）和非常主要错误率（VME < 3%）与参考方法进行比较。 1.

在 15.8% 的大肠杆菌和 75% 的克雷伯氏菌中检测到磷霉素耐药性。使用参考方法分离。圆片扩散法显示，大肠杆菌分离物中的CA 为 89.5%，ME 为 12.5 %，克雷伯菌属中的CA 为 75%，ME 为 100% 。隔离。两种方法均未检测到 VME。快速磷霉素 NP 方法导致大肠杆菌分离株的CA 96.4%、ME 0.0%、VME 22.2 %，以及克雷伯氏菌的CA 77.3%、ME 81.8% 和 VME 3% 。隔离。

我们相信来自大肠杆菌和克雷伯氏菌属的磁盘扩散试验和快速磷霉素 NP 的结果。分离株与参考方法不兼容，不应用作琼脂稀释方法的替代方法。