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Mutations in the murA gene, which encodes the MurA enzyme, can result in the substitution of the active site cysteine (Cys115) with other amino acids, such as Cys115Asp or Cys115Glu, thereby reducing its affinity for fosfomycin ( murA gene can dilute the intracellular fosfomycin concentration, effectively lowering the drug level within the cell and enabling bacteria to acquire resistance at a low fitness cost ( Pseudomonas species are considered to have inherent resistance to fosfomycin

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20 Packer L, Tritschler HJ, Wessel K

Dai et al., 2020)