The fosfomycin breakpoint using the disc diffusion method (DDM) changed in the 2019 CA-SFM/EUCAST guidelines 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 using the DDM and the broth microdilution method (BMD), respectively. The DDM with the 19-mm breakpoint was in accordance with the BMD. Using the 24-mm breakpoint, the overall rate of fosfomycin resistance in Enterobacterales increased by three-fold (5.6% vs 18.1%, P < 0.01) and reached 2.8% and 86.5% in E. coli and K. pneumoniae, respectively. French guidelines for the management of community-acquired UTI remain appropriate. The accuracy of the 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. coli should be evaluated considering its rate of resistance and recent data reporting low accuracy.

使用圆盘扩散法 (DDM) 的磷霉素断点在 2019 CA-SFM/EUCAST 指南 v2 中发生了变化（24 毫米对 19 毫米）。我们评估了它对从急诊科尿液样本中回收的肠杆菌属分类的影响。分别使用 DDM 和肉汤微量稀释法 (BMD) 测试了总共 7749 和 2348 株菌株。具有 19 毫米断点的 DDM 与 BMD 一致。使用 24 毫米断点，肠杆菌中磷霉素耐药的总体比率增加了三倍（5.6% 对 18.1%，P  < 0.01），在大肠杆菌和肺炎克雷伯菌中分别达到 2.8% 和 86.5%， 分别。法国社区获得性 UTI 管理指南仍然适用。应评估常规磷霉素药敏试验方法的准确性。磷霉素在治疗由大肠杆菌以外的肠杆菌引起的已记录 CA-UTI中的作用应考虑其耐药率和最近报告的低准确性数据进行评估。