title: Multi-drug resistant uropathogenic Escherichia coli and its treatment by Chinese medicine.
abstract: OBJECTIVE
  To investigate the resistance and virulence profiles of uropathogenic Escherichia coli (UPEC) and its treatment by Chinese medicine (CM) Fuzheng Qingre Lishi Formula (, FQLF).
  
  
  METHODS
  UPEC strains were isolated from recurrent urinary tract infections (UTIs) patients. Patient sensitivities to 17 antibiotics were tested by the disk diffusion method. Virulence genes were screened by plolymerase chain reaction. A mouse model was constructed using a multi-drug resistant and virulent UPEC strain and treated with FQLF or the antibiotic imipenem. The treatment efficacy was evaluated by bacterial clearance from urine and the urinary organs.
  
  
  RESULTS
  A total of 90 UPEC strains were collected, and 94.4% of the isolates were resistant to at least 1 antibiotic. Approximately 66.7% of the UPEC strains were multi-drug resistant. More than one virulence gene was found in 85.6% of the isolates. The extended-spectrum β-lactamases (ESBL)-positive strains were more resistant than the negative ones. The virulence gene number was positively correlated with the resistance number (P<0.05). A mouse model was successfully constructed using UPEC10. Treatment with either FQLF or antibiotics significantly cleared bacteria from the mouse urine after 14 days. In the untreated control, the bacteria lasted for 28 days. FQLF treatment of the UTI mouse model greatly reduced the bacterial number in the kidney and bladder, but could not completely clear the bacteria.
  
  
  CONCLUSIONS
  Multi-drug resistance is common among UPEC isolates, and the resistance is positively related with virulence. FQLF could treat UPEC UTIs, but could not completely clear the bacteria from the host.
authors.affiliation: Department of Endocrinology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China.
authors.forename: Shi-Wei
authors.initials: SW
authors.lastname: Liu
authors.affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, 100071, China.
authors.forename: Xiao-Yang
authors.initials: XY
authors.lastname: Xu
authors.affiliation: Department of Clinical Laboratory, The First Affiliated, Hospital of Soochow University, Suzhou, Jiangsu Province, 215006, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Xu
authors.affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, 100071, China.
authors.forename: Jiu-Yun
authors.initials: JY
authors.lastname: Yuan
authors.affiliation: Institute of Integrative Medicine, Sun Yat-sen University, Guangzhou, 510275, China.
authors.forename: Wei-Kang
authors.initials: WK
authors.lastname: Wu
authors.affiliation: Department of Endocrinology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, 100071, China. zeliangchen@126.com.
authors.forename: Ze-Liang
authors.initials: ZL
authors.lastname: Chen
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D004365:Drugs, Chinese Herbal / Q000494:pharmacology* / Q000627:therapeutic use; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D015378:Imipenem / Q000494:pharmacology / Q000627:therapeutic use; D008807:Mice, Inbred BALB C; D009928:Organ Specificity / Q000187:drug effects; D016896:Treatment Outcome; D056689:Uropathogenic Escherichia coli / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D014774:Virulence / Q000187:drug effects / Q000235:genetics
chemical_list: D004365:Drugs, Chinese Herbal; D015378:Imipenem
keywords: Chinese medicine; multi-drug resistance; urinary tract infection; uropathogenic Escherichia coli