A disseminated multidrug-resistant clonal group of uropathogenic Escherichia coli in pyelonephritis.
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.
Johnson
James R
JR
Medical Service, Minneapolis VA Medical Center and Department of Medicine, University of Minnesota, Minneapolis, MN, USA. johns007@tc.umn.edu
Manges
Amee R
AR
O'Bryan
Timothy T
TT
Riley
Lee W
LW
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*
D015662:Trimethoprim, Sulfamethoxazole Drug Combination