murA, uhpT, glpT and fosA Genes of Fosfomycin Resistance in Multi-drug Resistant E. coli Isolated from Hematological Malignancies' Patients with Blood Stream Infection

Aim: To estimate the prevalence of murA, uhpT, glpT and fosA resistance genes of fosfomycin in multidrug resistant Escherichia coli isolated from patients suffering from hematological malignancies with on top blood stream infection together with correlating this distribution to the rate of expression of AmpC, ESBLs and MBLs in such isolates.

Methods: 205 blood samples collected from patients with underlying hematological malignancies were cultured to isolate E. coli strains. Multidrug resistance was detected. PCR was done to determine fosfomycin resistance genes; murA, uhpT, glpT and fosA.

Results: A total of 83 (40.5%) E. coli strains were isolated from blood samples. 58 (69.9%) were found to be multidrug resistant. AmpC beta-lactamase production was deduced in 15 (25.8%) isolates. 43 (74.1%) isolates were ESBLs producers whereas 9 (15.5%) were MBL class A carbapene-mases producers. Depending on PCR results, murA gene was detected in one isolate (1.7%), uhpT gene in 3 (5.2%), glpT gene in 4 (6.9%) whereas fosA gene was found in 7 E. coli strains (12.1%).

Conclusion: Fosfomycin is a promising antibiotic with limited degree of prevalence of its resistant genes; however disseminating resistance might increase in multidrug resistant E. coli