Molecular epidemiology of multi-resistant Escherichia coli
| Autor: | A. Guyot, E. J. Threlfall, T. Cheasty, M.D. Hampton, S.P. Barrett |
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| Rok vydání: | 1999 |
| Předmět: |
DNA
Bacterial Male Microbiology (medical) Genotype medicine.drug_class Antibiotics Microbial Sensitivity Tests medicine.disease_cause Microbiology Anti-Infective Agents Ciprofloxacin Risk Factors London Escherichia coli medicine Pulsed-field gel electrophoresis Humans Terminally Ill Escherichia coli Infections Aged Cephalosporinase Antibacterial agent Cross Infection Molecular epidemiology business.industry Drug Resistance Microbial General Medicine Middle Aged Antimicrobial Drug Resistance Multiple Electrophoresis Gel Pulsed-Field Infectious Diseases Case-Control Studies Urinary Tract Infections Female business medicine.drug |
| Zdroj: | Journal of Hospital Infection. 43:39-48 |
| ISSN: | 0195-6701 |
| DOI: | 10.1053/jhin.1999.0637 |
| Popis: | In this case-control study multi-resistant Escherichia coli isolates were characterized on a molecular level and risk factors for their development were identified. Thirty-two multi-resistant E. coli strains were isolated from the urine of 13 patients attending a renal clinic for chronic urinary tract infection (UTI) and from different sites of 11 terminally ill patients with nosocomial infections hospitalized on five different wards. All 32 isolates were resistant to ciprofloxacin, cotrimoxazole and produced beta-lactamase. All strains contained plasmids of 2-110 MDa of which a 50 MDa and a 100 MDa plasmid were present in 81% of the strains. Pulse-field gel electrophoresis (PFGE) analysis demonstrated 17 genotypes among 32 strains which indicates a polyclonal outbreak with some geographic clustering. Monitoring of patients over the study period showed that either the resident genotype remained the same and that these retained strains underwent changes in their plasmid contents, or that they were replaced by a different genotype after several months of therapy for chronic UTI. Univariate analysis indicated that multi-resistant E. coli develop in the presence of long-term selective ciprofloxacin pressure at a dosing regimen of 250 mg bid for more than 20 days and that treatment with a broad spectrum antimicrobial for more than three days favours the selection of multi-resistant E. coli in the flora of terminally ill patients with multiple disorders. |
| Databáze: | OpenAIRE |
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