title: Association between antibiotic resistance and the expression of Dr adhesin among uropathogenic Escherichia coli.
abstract: BACKGROUND
  Urinary tract infections (UTIs) are a significant health problem and Escherichia coli has been exported to be the primary pathogen in approximately 80% of cases. E. coli express structures called adhesins, fimbriae or pili that help them bind to specific tissue receptors. One such adhesin is Dr, which binds to the complement decay-accelerating factor (CD55) on the host cell. The purpose of the present study was to review the epidemiology and antimicrobial sensitivity spectrum of Dr adhesin-bearing E. coli isolates in women with UTI.
  
  
  RESULTS
  A total of 337 uropathogenic E. coli isolates were collected, and mannose-resistant hemagglutination was observed in 43%, while 12.4% expressed Dr adhesin. All 337 uropathogenic E. coli isolates were found to be resistant to penicillin, oxacillin, bactericin and cloxacillin. None of the isolates was resistant to quinolones. The resistance to sulfamethoxazole was most common (90%), followed by nalidixic acid (51%) and ampicillin (41%). Interestingly, uropathogenic E. coli expressing Dr adhesin had a high incidence of ampicillin resistance (83%), and only 17% of the Dr-bearing isolates were found to be resistant to an ampicillin/sulbactum combination.
  
  
  CONCLUSIONS
  These results indicate that UTIs may be successfully treated with ampicillin in combination with a beta-lactamase inhibitor, so that selective colonization by Dr adhesin-bearing uropathogenic E. coli is prevented, which is probably promoted by treating these patients with ampicillin alone.
authors.affiliation: Department of Obstetrics and Gynecology, Medical School, University of Minnesota, Minneapolis, MN, USA.
authors.forename: B B
authors.initials: BB
authors.lastname: Kachroo
mesh_terms: D018830:Adhesins, Escherichia coli / Q000145:classification / Q000187:drug effects / Q000378:metabolism*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002939:Ciprofloxacin / Q000494:pharmacology; D004352:Drug Resistance, Microbial / Q000502:physiology; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000382:microbiology; D005260:Female; D006386:Hemagglutination Tests; D006801:Humans; D008358:Mannose / Q000378:metabolism; D008826:Microbial Sensitivity Tests; D009428:Netilmicin / Q000494:pharmacology; D010068:Oxacillin / Q000494:pharmacology; D014552:Urinary Tract Infections / Q000382:microbiology*
chemical_list: D018830:Adhesins, Escherichia coli; D000900:Anti-Bacterial Agents; D009428:Netilmicin; D002939:Ciprofloxacin; D008358:Mannose; D010068:Oxacillin