Méningite bactérienne à Capnocytophaga canimorsus

International audienceNous présentons ici un cas de méningite à C. canimorsus compliquée d’une CIVD avec défaillance multiviscérale (rénale, hépatique et respiratoire) et nécrose des extrémités ayant nécessité une prise en charge chirurgicale

Fosfomycin, from susceptibility to resistance: Impact of the new guidelines on breakpoints

The fosfomycin breakpoint using the disc diffusion method (DDM) changed in the 2019 CA-SFM/EUCASTguidelines v2 (24 mm versus 19 mm).We assessed its impact on categorization of Enterobacterales recovered from urine samples in emergency departments. A total of 7749 and 2348 strains were tested usingthe DDM and the broth microdilution method (BMD), respectively. The DDM with the 19-mm breakpointwas in accordance with the BMD. Using the 24-mm breakpoint,the overall rate offosfomycin resistance inEnterobacterales increased by three-fold (5.6% vs 18.1%, P < 0.01) and reached 2.8% and 86.5% in E. coli andK. pneumoniae, respectively. French guidelines for the management of community-acquired UTI remainappropriate. The accuracy ofthe methods for routine fosfomycin susceptibility testing should be assessed.The role of fosfomycin in the treatment of documented CA-UTI due to Enterobacterales other than E. colishould be evaluated considering its rate of resistance and recent data reporting low accuracy