Phylogenetic Background and Virulence Profiles of Fluoroquinolone‐Resistant Clinical<i>Escherichia coli</i>Isolates from The Netherlands

Johnson, James R.; Schee, Cindy van der; Kuskowski, Michael A.; Goessens, W. H. F.; Belkum, Alex van

doi:10.1086/345767

Cited by 60 publications

(62 citation statements)

References 17 publications

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“…For RUTIs, by assessing the frequent clonality of consecutive E. coli strains, we succeeded in showing that increasing resistance is not the main goal of persisting bacteria. A negative correlation between resistance and the expression of virulence factors has been found in several previous studies (24,53,54). Possibly, some other virulence factors, such as tissue invasion, capsulation, or slime production, may be promoted in clonal strains.…”

Section: Discussionmentioning

confidence: 62%

Persistence of Escherichia coli Clones and Phenotypic and Genotypic Antibiotic Resistance in Recurrent Urinary Tract Infections in Childhood

et al. 2009

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We assessed the clonality of consecutive Escherichia coli isolates during the course of recurrent urinary tract infections (RUTI) in childhood in order to compare clonality with phenotypic antibiotic resistance patterns, the presence of integrons, and the presence of the sul1, sul2, and sul3 genes. Altogether, 78 urinary E. coli isolates from 27 children, who experienced recurrences during a 1-year follow-up after the first attack of acute pyelonephritis, were investigated. The MICs of sulfamethoxazole, trimethoprim-sulfamethoxazole (SXT), ampicillin, cefuroxime, cefotaxime, and gentamicin and the presence or absence of the intI gene for class 1 integrons and the sulfamethoxazole resistance-encoding genes sul1, sul2, and sul3 were determined. All E. coli strains were genotyped by pulsed-field gel electrophoresis. There were no significant differences in the prevalences of resistance to beta-lactams and SXT between initial and consecutive E. coli isolates (41 versus 45% and 41 versus 29%, respectively). However, the E. coli strains obtained after SXT administration more frequently carried two or more sul genes than the nonexposed strains (9/21 [43%] versus 11/57 [19%], respectively; P ‫؍‬ 0.044). In 78% of the patients, the recurrence of unique clonal E. coli strains alone or combined with individual strains was detected. Phenotypic resistance and the occurrence of sul genes were more stable in clonal strains than in individual strains (odds ratios, 8.7 [95% confidence interval {95% CI}, 1.8 to 40.8] and 4.4 [95% CI, 1.1 to 17.7], respectively). Thus, in children with RUTIs, the majority of E. coli strains from consecutive episodes are unique persisting clones, with rare increases in the initially high antimicrobial resistance, the presence of sul genes, and the presence of integrons.Persistent urinary tract infections usually emerge in early childhood. Approximately 1 to 8% of children between the ages of 1 month and 11 years have experienced at least one urinary tract infection (23,31,41,42). Recurrent urinary tract infection (RUTI) endangers renal function; even the first episode of acute pyelonephritis can lead to renal scarring in 9.5% to 57% of cases, according to Hoberman et al. (17) and Lin et al. (34), respectively. In childhood the most important risk factor for RUTI has been considered to be the presence of vesicourinary reflux, alone or combined with dysfunctional voiding (3,49,58).The second important risk factor is closely associated with antimicrobial therapy for RUTI. In children, as in adults, the most frequent urinary pathogen is Escherichia coli, and the prevailing treatment schemes include the beta-lactam antibiotics, trimethoprim-sulfamethoxazole (SXT), and aminoglycosides (1, 25). However, increased resistance among urinary E. coli strains to some beta-lactam antibiotics and SXT has been reported in different countries (18,27). Furthermore, children with vesicourinary reflux require long-term antimicrobial prophylaxis (20, 39), usually with SXT or nitrofurantoin. This, in turn, can select ...

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Section: Discussionmentioning

confidence: 62%

Persistence of Escherichia coli Clones and Phenotypic and Genotypic Antibiotic Resistance in Recurrent Urinary Tract Infections in Childhood

et al. 2009

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“…Recent studies have demonstrated a relationship between phylogenetic origin and antibiotic resistance and low prevalence of VFs (8,10). In a previous study, phylotypes were not taken into account, and the presence of some low-virulence phylotypes, such as phylotype A, may explain the lower prevalence of VFs found among quinolone-resistant E. coli strains in our series.…”

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confidence: 60%

“…However, in vitro studies (unpublished data) suggest a decreased pathogenicity of E. coli associated with the acquisition of quinolone resistance itself. To study whether the absence of VFs is associated with resistance specifically within phylogenetic group B2, we investigated the prevalence of 31 VFs among quinolone-resistant versus quinolone-susceptible E. coli urinary tract infection (UTI) isolates, all belonging to phylogenetic group B2 (the most virulent; not intrinsically related to quinolone resistance, as shown for phylogenetic group A) (10). The prevalence of the studied VFs according to susceptibility to ampicillin, cotrimoxazole, and gentamicin was also assessed.…”

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confidence: 99%

Quinolone-Resistant Uropathogenic Escherichia coli Strains from Phylogenetic Group B2 Have Fewer Virulence Factors than Their Susceptible Counterparts

et al. 2005

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The prevalence of 31 virulence factors was analyzed among nalidixic acid-susceptible and -resistant Escherichia coli strains from phylogenetic group B2. Hemolysin, cytotoxic necrotizing factor 1, and S and F1C fimbriae genes were less prevalent among nalidixic acid-resistant E. coli strains. Quinolone resistance may be associated with a decrease in the presence of some virulence factors.Extraintestinal pathogenic Escherichia coli (ExPEC) strains have multiple virulence factors (VFs) that confer the potential for pathogenicity (6). Recently, extended virulence genotypes have been reported for ExPEC isolates from patients with diverse extraintestinal syndromes (9). E. coli strains derive from different phylogenetic groups (5). Pathogenic E. coli strains derive mainly from the more virulent phylogenetic group B2 (3,7,13).Recent data suggest that quinolone-resistant ExPEC are less able to cause upper urinary tract infection and have fewer VFs than quinolone-susceptible E. coli (14,15). Some studies have related quinolone resistance and low virulence with phylogenetic origin (8). However, in vitro studies (unpublished data) suggest a decreased pathogenicity of E. coli associated with the acquisition of quinolone resistance itself. To study whether the absence of VFs is associated with resistance specifically within phylogenetic group B2, we investigated the prevalence of 31 VFs among quinolone-resistant versus quinolone-susceptible E. coli urinary tract infection (UTI) isolates, all belonging to phylogenetic group B2 (the most virulent; not intrinsically related to quinolone resistance, as shown for phylogenetic group A) (10). The prevalence of the studied VFs according to susceptibility to ampicillin, cotrimoxazole, and gentamicin was also assessed.E. coli strains isolated from urine from patients with acute pyelonephritis, acute cystitis, or acute prostatitis who presented at our department were identified by conventional biochemical tests. Cystitis, acute pyelonephritis, and acute prostatitis were defined as they were defined previously elsewhere (12). Fifty-three E. coli isolates causing acute pyelonephritis in women, 19 causing cystitis in women, and 13 causing prostatitis in men were analyzed.Susceptibilities to nalidixic acid, ciprofloxacin, ampicillin, cotrimoxazole, and gentamicin were tested by the E-test method (AB Biodisk, Sölna, Sweden). All isolates were assigned to phylogenetic group B2 with the use of the multiplex PCR-based method (1), and all isolates belonged to different clones by Rep-PCR. Extended virulence genotypes, including 31 individual VFs and papA alleles, were determined by multiplex PCR assays and dot blot hybridization, as previously described (7). In addition, sat (secreted autotransporter toxin) was detected using previously described PCR conditions and primers (15). Each isolate was tested in duplicate, in parallel with appropriate positive and negative controls.Statistical analyses were performed by using Fisher's exact and chi-square tests. Stratified analysis was performed by mean...

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“…This has been interpreted as loss of virulence factors concomitant with mutation to resistance [43]. However, this hypothesis does not account for the phylogenetic shifts (away from group B2) observed among resistant isolates, which suggest that resistant isolates derive primarily from distinct, less virulent bacterial populations [44,45].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic resistance and virulence genes of extraintestinal pathogenic Escherichia coli from tropical estuary, south India

Sukumaran

Hatha

2015

J Infect Dev Ctries

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Introduction: Escherichia coli strains can cause a variety of intestinal and extraintestinal diseases. Extraintestinal pathogenic E. coli (ExPEC) strains have the ability to cause severe extraintestinal infections. Multidrug resistance among ExPEC could complicate human infections. Methodology: Escherichia coli strains were isolated during the period of January 2010 to December 2012 from five different stations set at Cochin estuary. Susceptibility testing was determined by the disk-diffusion method using nine different antimicrobial agents. A total of 155 strains of Escherichia coli were screened for the presence of virulence factor genes including papAH, papC, sfa/focDE, iutA,and kpsMT II associated with ExPEC. Results: Among the 155 E. coli isolates, 26 (16.77%), carried two or more virulence genes typical of ExPEC. Furthermore, 19.23% of the ExPEC isolates with multidrug resistance were identified to belong to phylogenetic groups B2 and D. Statistically significant association of iutA gene in ExPEC was found with papC (p < 0.001) and kpsMT II (p < 0.001) genes. ExPEC isolates were mainly resistant to ampicillin (23.07%), tetracycline (19.23%), co-trimoxazole (15.38%), and cefotaxime (15.38%). The adhesion genes papAH and sfa/focDE were positively associated with resistance to gentamicin, chloramphenicol, and cefotaxime (p < 0.05). Conclusions: Co-occurrence of virulence factor genes with antibiotic resistance among ExPEC poses considerable threat to those who use this aquatic system for a living and for recreation.

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Phylogenetic Background and Virulence Profiles of Fluoroquinolone‐Resistant ClinicalEscherichia coliIsolates from The Netherlands

Cited by 60 publications

References 17 publications

Persistence of Escherichia coli Clones and Phenotypic and Genotypic Antibiotic Resistance in Recurrent Urinary Tract Infections in Childhood

Persistence of Escherichia coli Clones and Phenotypic and Genotypic Antibiotic Resistance in Recurrent Urinary Tract Infections in Childhood

Quinolone-Resistant Uropathogenic Escherichia coli Strains from Phylogenetic Group B2 Have Fewer Virulence Factors than Their Susceptible Counterparts

Antibiotic resistance and virulence genes of extraintestinal pathogenic Escherichia coli from tropical estuary, south India

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