title: A disseminated multidrug-resistant clonal group of uropathogenic Escherichia coli in pyelonephritis.
abstract: In acute pyelonephritis, bacterial resistance to co-trimoxazole predicts treatment failure, but the clonal basis of such resistance is undefined. We did molecular and serological analyses of 170 Escherichia coli urine isolates obtained in 1994-96 from women with acute pyelonephritis. 12 (7%) of the pyelonephritis isolates were in clonal group A (CGA; responsible for 38-51% of co-trimoxazole resistance in acute cystitis), including ten (34%) of 29 isolates that were resistant to co-trimoxazole. CGA isolates were obtained from diverse locations across the USA and were related to the O15:K52:H1 clone of the 1986-87 outbreak in London, UK. Thus, CGA is broadly disseminated and contributes to co-trimoxazole resistance in pyelonephritis as well as in cystitis.
authors.affiliation: Medical Service, Minneapolis VA Medical Center and Department of Medicine, University of Minnesota, Minneapolis, MN, USA. johns007@tc.umn.edu
authors.forename: James R
authors.initials: JR
authors.lastname: Johnson
authors.forename: Amee R
authors.initials: AR
authors.lastname: Manges
authors.forename: Timothy T
authors.initials: TT
authors.lastname: O'Bryan
authors.forename: Lee W
authors.initials: LW
authors.lastname: Riley
mesh_terms: D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects* / Q000472:pathogenicity; D005260:Female; D005838:Genotype; D006801:Humans; D016133:Polymerase Chain Reaction; D011704:Pyelonephritis / Q000188:drug therapy* / Q000652:urine; D012703:Serotyping; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*
chemical_list: D015662:Trimethoprim, Sulfamethoxazole Drug Combination