We studied 137 uropathogenic Escherichia coli (UPEC) isolates from hospitalized adult patients (Queensland, Australia) for their resistance to 17 antimicrobial agents using the calibrated dichotomous sensitivity method and the presence of class I, II and III integron-associated integrase (intI) genes, including functional class II intI2, as well as the presence of sul1, sul2 and sul3 genes, using PCR. Randomly amplified polymorphic DNA PCR, a high-resolution biochemical-fingerprinting method (PhP) and phylogenetic grouping were also used to identify the clonality of the sulphonamide-resistant isolates. One hundred and twenty (87.6 %) isolates were resistant to one or more of the tested antimicrobial drugs, with the highest resistance (70.1 %) observed against sulphafurazole (96 isolates). Of these, 84 (87.5 %) contained one or more sul alleles, with sul1 being the most common allele [occurring in 69 (72 %) isolates]. Only 38 of 69 (55.1 %) strains carrying the sul1 gene were positive for class I integrase. Our results indicate a high prevalence of sulphafurazole-resistant UPEC strains belonging to different clones among patients with urinary tract infection in Queensland, Australia. We also conclude that these strains carry predominantly a sul1 gene that is not commonly associated with the presence of class I integrase, indicating that it may be carried on either a bacterial chromosome or other genetic elements.
INTRODUCTIONUrinary tract infection (UTI), although one of the most easily treatable diseases, has been reported to be the most common hospital-acquired infection, affecting mainly women, children and the elderly (Foxman & Brown, 2003;Gupta et al., 2001;Russo & Johnson, 2003;Tartof et al., 2007). Escherichia coli is the primary aetiological agent, accounting for 75-90 % cases of UTI (Gupta et al., 2001;Kaper et al., 2004;Nicolle, 2002). The acquisition of resistance genes by horizontal transfer is currently thought to play a major role in the development of multi-drugresistant (MDR) strains because a substantial proportion of the resistance genes are located on conjugative plasmids, transposons, insertion sequences and integrons (Chang et al., 2011;Fierer & Guiney, 1999;Moritz & Hergenrother, 2006). Integrons are mobile DNA elements with the ability to integrate and express gene cassettes by site-specific recombination (Mazel, 2006;Rowe-Magnus & Mazel, 2002). Site-specific recombination is catalysed by an integrase that is encoded within the conserved 59 region of integrons. Several classes of integrase have been described with those classes of integrons, i.e. class I integrase (intI1) defines class I integrons (Collis et al., 2002;Nield et al., 2001).With the standard treatment for UTI being a combination of trimethoprim and sulphamethoxazole (Grape et al., 2003), the sulphonamides are classified as a highly important antimicrobial agent for treatment of E. coli infections, and the presence of sulphonamide resistance can lead to treatment failure in cases of UTI. In E. coli, sulphonamide resistance ofte...