Pyelonephritis caused by multiple clones of Escherichia coli, susceptible and resistant to co-amoxiclav, after a 45 day course of co-amoxiclav.
OBJECTIVE
We studied the clonal relatedness, in terms of phylogenetic group, virulence factors and co-amoxiclav resistance, of different Escherichia coli isolates obtained from blood and urine of a patient who had taken a 45 day course of co-amoxiclav.


METHODS
The isolates were typed by molecular methods, and the virulence and resistance genes studied by PCR.


RESULTS
The four phenotypically different E. coli isolates were classified into four clones and two phylogenetic groups (B2 and A), and displayed different virulence gene patterns. The two isolates resistant to co-amoxiclav were phylogenetically and clonally different, and harboured two different bla(TEM) genes.


CONCLUSIONS
These two bla(TEM) genes did not derive from each other following a mutant selection process in vivo.
Leflon-Guibout
Véronique
V
Service de Microbiologie, Hôpital Ambroise Paré (AP-HP), Faculté de Médecine Paris-Ouest, Université Paris V, Boulogne, France.
Bonacorsi
Stéphane
S
Clermont
Olivier
O
Ternat
Géraldine
G
Heym
Beate
B
Nicolas-Chanoine
Marie-Hélène
MH
D019980:Amoxicillin-Potassium Clavulanate Combination / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D004926:Escherichia coli / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011704:Pyelonephritis / Q000188:drug therapy* / Q000382:microbiology*
D019980:Amoxicillin-Potassium Clavulanate Combination