Widespread distribution of urinary tract infections caused by a multidrug-resistant Escherichia coli clonal group
Widespread distribution of urinary tract infections caused by a multidrug-resistant Escherichia coli clonal group
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DOI：
10.1056/nejmoa011265
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发表时间：
2001-10-04
影响因子：
158.5
通讯作者：
Riley, LW
中科院分区：
文献类型：
--
作者：
Manges, AR;Johnson, JR;Riley, LW
背景：由于耐药菌株的增加，尿路感染的治疗变得更加复杂。我们研究了社区获得性尿路感染妇女分离的耐甲氧氨嘧啶-磺胺甲恶唑的大肠埃希菌的克隆性组成。方法：前瞻性收集加州某大学社区女性尿路感染患者的大肠埃希菌进行药敏试验、O：H血清型、DNA指纹图谱、脉冲场凝胶电泳谱和毒力因子分析。对这组分离株以及密歇根州和明尼苏达州的对照队列中的耐药克隆的流行率和特征进行了评估。结果：加利福尼亚州队列中的255株大肠埃希菌中，55株(22%)对甲氧苄氨嘧啶-磺胺甲恶唑和其他抗生素具有耐药性。有一个共同的DNA指纹图谱，表明这些菌株属于同一克隆组(克隆组A)，55株甲氧嘧啶-磺胺甲恶唑耐药株中有28株(51%)，50株随机选择的甲氧嘧啶-磺胺甲恶唑敏感株中有2株(4%，P
Background: The management of urinary tract infections is complicated by the increasing prevalence of antibiotic-resistant strains of Escherichia coli. We studied the clonal composition of E. coli isolates that were resistant to trimethoprim-sulfamethoxazole from women with community-acquired urinary tract infections.Methods: Prospectively collected E. coli isolates from women with urinary tract infections in a university community in California were evaluated for antibiotic susceptibility, O:H serotype, DNA fingerprinting, pulsed-field gel electrophoretic pattern, and virulence factors. The prevalence and characteristics of an antibiotic-resistant clone were evaluated in this group of isolates and in those from comparison cohorts in Michigan and Minnesota.Results: Fifty-five of the 255 E. coli isolates (22 percent) from the California cohort were resistant to trimethoprim-sulfamethoxazole as well as other antibiotics. There was a common pattern of DNA fingerprinting, suggesting that the isolates belonged to the same clonal group (clonal group A), in 28 of 55 isolates with trimethoprim-sulfamethoxazole resistance (51 percent) and in 2 of 50 randomly selected isolates that were susceptible to trimethoprim-sulfamethoxazole (4 percent, P