Fluoroquinolone-resistant uropathogenic Escherichia coli in Norway: evidence of clonal spread

Grude, Nils; Strand, Linda M.; Mykland, Hilde-Christine; Nowrouzian, Forough L.; Nyhus, Jørgen; Jenkins, Andrew; Kristiansen, B.

doi:10.1111/j.1469-0691.2008.01952.x

Cited by 17 publications

(15 citation statements)

References 16 publications

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“…In contrast, fluoroquinolone resistance remained low in other parts of the world. For example, fluoroquinolone resistance in E. coli UTI isolates remains low at 1.2% in Norway [17] . In the USA and other parts of the world, fluoroquinolones are the first-line treatment for uncomplicated UTI where resistance to TMP-SMX is prevalent.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibility Pattern of Bacterial Pathogens Causing Urinary Tract Infections in a Saudi Arabian Hospital

Al‐Tawfiq¹,

Anani

2009

Chemotherapy

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The study describes the pathogens causing urinary tract infections (UTI) and the antimicrobial susceptibility pattern of health care-associated (HCA) and community-acquired (CA) isolates. Of the total of 3,989 nonrepetitive urinary cultures, 4.7% (n = 188) were HCA and 95.3% (n = 3,801) were CA isolates. Gram-negative organisms totaled 3,607 (90.4%) vs. 9.6% Gram-positive organisms. In CA-UTI, Escherichia coli, Klebsiella pneumoniae and Enterococcus faecalis constituted 66, 11.4, and 5.4%, respectively. HCA-UTI episodes were caused by E. coli (37.8%), K. pneumoniae (14.4%) and Pseudomonas aeruginosa (6.4%). The susceptibility rates of E. coli to ciprofloxacin, trimethoprim-sulfamethoxazole (TMP-SMX), nitrofurantoin and ceftriaxone in HCA and CA isolates were 53.3 and 74.1%, 42.2 and 62.7%, 32.5 and 97.0%, and 62.3 and 92.7%, respectively. Extended-spectrum β-lactamase production was detected in 8.1 and 7.4% isolates, respectively, of CA and HCA isolates of E. coli. CA isolates of K. pneumoniae were more susceptible to TMP-SMX (89.2 vs. 60.4%), ciprofloxacin (92.6 vs. 67.9%) and cefuroxime (93.8 vs. 24.5%) than HCA isolates. The susceptibility of HCA and CA isolates of E. faecalis to penicillin G and nitrofurantoin were 34.8 and 80%, and 78.3 and 93.6%, respectively (p < 0.001). In conclusion, antimicrobial resistance is high to commonly used oral agents, rendering them inappropriate for empirical use.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibility Pattern of Bacterial Pathogens Causing Urinary Tract Infections in a Saudi Arabian Hospital

Al‐Tawfiq¹,

Anani

2009

Chemotherapy

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“…3,4 The increasing emergence of ciprofloxacin-resistant E. coli isolates may be due to either the selection of different ciprofloxacin-resistant strains or to clonal dissemination. While some studies have suggested clonal spread of fluoroquinolone-resistant E. coli isolates, 5 other studies found no clonal spread. 1 Despite the high incidence of fluoroquinolone resistance in E. coli isolates from Korea, genotypic characteristics of them have rarely been investigated.…”

Section: Introductionmentioning

confidence: 97%

Dissemination of ST131 and ST393 community-onset, ciprofloxacin-resistant Escherichia coli clones causing urinary tract infections in Korea

Lee

Choi

et al. 2010

Journal of Infection

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“…The problem of emerging ciprofloxacin resistance is further compounded by its frequent association with multiresistance to other antibiotics [8-13]. The reason for this association is not understood, but several possibilities may be considered.…”

Section: Introductionmentioning

confidence: 99%

“…The reason for this association is not understood, but several possibilities may be considered. Ciprofloxacin-resistant isolates have been reported to show a high level of clonality [8,14] and resistance has emerged in the multiresistant uropathogenic clonal group A (CGA) [15-20], which suggests a contribution from the spread of multiresistant clones under selection pressure. The agricultural sector has also been suggested as a source of ciprofloxacin resistance [21], in which case multiresistance might arise at source, driven by the extensive use of antibiotic additives as growth stimulants in animal feed.…”

Section: Introductionmentioning

confidence: 99%

High levels of multiresistance in quinolone resistant urinary tract isolates of Escherichia coli from Norway; a non clonal phenomen?

et al. 2014

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BackgroundThe problem of emerging ciprofloxacin resistance is compounded by its frequent association with multiresistance, the reason for which is not fully understood. In this study we compare multiresistance, clonal similarities and phylogenetic group in urinary tract isolates of Escherichia coli sensitive and resistant to the quinolone antimicrobials nalidixic acid and ciprofloxacin.ResultsQuinolone resistant isolates were more resistant to non-quinolone antibiotics than sensitive isolates, with resistance to ampicillin, mecillinam, sulphonamide, trimethoprim, tetracycline, kanamycin and chloramphenicol significantly increased. Fifty-one percent of quinolone-resistant isolates were multiresistant. Although multiresistance was most prevalent (63%) in isolates showing high-level ciprofloxacin resistance, it was still highly prevalent (41%) in nalidixic acid resistant isolates with low-level ciprofloxacin resistance. Multiresistance was more frequent among singleton isolates (61%) than clonal isolates (40%) of quinolone resistant Escherichia coli. Ciprofloxacin resistance was associated with certain specific clones, among them the globally distributed clonal Group A. However, there was no significant difference in the overall degree of clonality between quinolone sensitive and resistant isolates. Ciprofloxacin resistance was positively associated with phylogroup D and negatively associated with phylogroup B2. This correlation was not associated with clonal isolates.ConclusionThis study supports earlier findings of association between ciprofloxacin resistance and resistance to other antibiotics. The prevalence of multiresistance in quinolone-resistant isolates that have not yet developed high-level ciprofloxacin resistance suggest that multiresistance arises early in the development of quinolone resistance. This is consistent with exposure to quinolones causing quinolone resistance by mutations and mobilization of multiresistance elements by induction of the SOS response. The spread of clones seems to be less important than previously reported in regard to emergence of quinolone resistance and multiresistance as both are associated primarily with singleton isolates.

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Fluoroquinolone-resistant uropathogenic Escherichia coli in Norway: evidence of clonal spread

Cited by 17 publications

References 16 publications

Antimicrobial Susceptibility Pattern of Bacterial Pathogens Causing Urinary Tract Infections in a Saudi Arabian Hospital

Antimicrobial Susceptibility Pattern of Bacterial Pathogens Causing Urinary Tract Infections in a Saudi Arabian Hospital

Dissemination of ST131 and ST393 community-onset, ciprofloxacin-resistant Escherichia coli clones causing urinary tract infections in Korea

High levels of multiresistance in quinolone resistant urinary tract isolates of Escherichia coli from Norway; a non clonal phenomen?

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