title: Pyelonephritis caused by multiple clones of Escherichia coli, susceptible and resistant to co-amoxiclav, after a 45 day course of co-amoxiclav.
abstract: 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.
authors.affiliation: Service de Microbiologie, Hôpital Ambroise Paré (AP-HP), Faculté de Médecine Paris-Ouest, Université Paris V, Boulogne, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Leflon-Guibout
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bonacorsi
authors.forename: Olivier
authors.initials: O
authors.lastname: Clermont
authors.forename: Géraldine
authors.initials: G
authors.lastname: Ternat
authors.forename: Beate
authors.initials: B
authors.lastname: Heym
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Nicolas-Chanoine
mesh_terms: 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*
chemical_list: D019980:Amoxicillin-Potassium Clavulanate Combination