High genetic diversity of nitrofurantoin- or mecillinam-resistant Escherichia coli indicates low propensity for clonal spread

J Antimicrob Chemother. 2013 Sep;68(9):1974-7. doi: 10.1093/jac/dkt159. Epub 2013 May 2.

Abstract

Objectives: 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).

Result: 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.

Keywords: antimicrobial resistance; successful clones; uncomplicated urinary tract infections.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amdinocillin / pharmacology*
  • Anti-Bacterial Agents / pharmacology
  • Canada / epidemiology
  • Cluster Analysis
  • Drug Resistance, Bacterial*
  • Escherichia coli / classification*
  • Escherichia coli / drug effects
  • Escherichia coli / genetics*
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / microbiology
  • Escherichia coli Infections / transmission
  • Europe / epidemiology
  • Female
  • Genetic Variation*
  • Genotype
  • Humans
  • Middle Aged
  • Molecular Epidemiology
  • Multilocus Sequence Typing
  • Nitrofurantoin / pharmacology*
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / transmission
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Nitrofurantoin
  • Amdinocillin