title: High genetic diversity of nitrofurantoin- or mecillinam-resistant Escherichia coli indicates low propensity for clonal spread.
abstract: OBJECTIVE
  The empirical treatment with trimethoprim or ciprofloxacin of urinary tract infections (UTIs) is now questioned, partly due to the global expansion of a few resistant clonal groups of Escherichia coli.
  
  
  METHODS
  In this study we investigated the clonal structure of 34 strains of E. coli (collected from non-pregnant women aged 18-65 years with uncomplicated UTIs in Europe and Canada) resistant to either of two other common treatment alternatives for uncomplicated UTIs, mecillinam or nitrofurantoin, using multilocus sequence typing (MLST).
  
  
  RESULTS
  The 34 isolates were, despite high levels of multiresistance, distributed all over the E. coli genetic diversity spectrum with little association of antibiotic resistance to specific clonal groups.
  
  
  CONCLUSIONS
  The results of this study indicate a low probability of a future clonal spread of resistance to mecillinam and nitrofurantoin.
authors: Department of Clinical Microbiology, Central Hospital, SE-351 85 Växjö, Sweden.
authors: Hanna O
authors: HO
authors: Poulsen
authors: Anders
authors: A
authors: Johansson
authors: Susanne
authors: S
authors: Granholm
authors: Gunnar
authors: G
authors: Kahlmeter
authors: Martin
authors: M
authors: Sundqvist
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000560:Amdinocillin / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002170:Canada / Q000453:epidemiology; D016000:Cluster Analysis; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000145:classification* / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D005060:Europe / Q000453:epidemiology; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D009582:Nitrofurantoin / Q000494:pharmacology*; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D009582:Nitrofurantoin; D000560:Amdinocillin
keywords: antimicrobial resistance; successful clones; uncomplicated urinary tract infections