Pulsed-Field Gel Electrophoresis Typing of Escherichia coli Strains from Samples Collected before and after Pivmecillinam or Placebo Treatment of Uncomplicated Community-Acquired Urinary Tract Infection in Women
- 1 May 2006
- journal article
- research article
- Published by American Society for Microbiology in Journal of Clinical Microbiology
- Vol. 44 (5), 1776-81
- https://doi.org/10.1128/jcm.44.5.1776-1781.2006
Abstract
The primary infecting Escherichia coli strains from 156 women with community-acquired uncomplicated urinary tract infection (UTI) randomized to pivmecillinam or placebo and the E. coli strains causing UTI at two follow-up visits were typed using pulsed-field gel electrophoresis (PFGE). In the pivmecillinam treatment group PFGE showed that among patients having a negative urine culture at the first follow-up 77% (46/60) had a relapse with the primary infecting E. coli strain and 23% (14/60) had reinfection with a new E. coli strain at the second follow-up. Among patients having E. coli at the first follow-up PFGE showed that 80% (32/40) had persistence with the primary infecting E. coli strain, 15% (6/40) had reinfection with a new E. coli strain, and 5% (2/40) had different E. coli strains at the two follow-up visits (one had reinfection followed by relapse, and the other had persistence followed by reinfection). In the placebo group the majority had E. coli at the first follow-up. PFGE showed that among these patients 96% (50/52) had persistence with the primary infecting E. coli strain and 4% (2/50) had different E. coli strains at the two follow-up visits (both had persistence followed by reinfection). The finding that the majority of UTIs at follow-up are caused by the primary infecting E. coli strain supports the theory of a vaginal and rectal reservoir but could also support the recent discovery that E. coli strains are able to persist in the bladder epithelium despite appropriate antibiotic treatment, constituting a reservoir for recurrent UTI.Keywords
This publication has 48 references indexed in Scilit:
- Intracellular persistence of Escherichia coli in urinary bladders from mecillinam-treated miceJournal of Antimicrobial Chemotherapy, 2005
- A European perspective on nosocomial urinary tract infections II. Report on incidence, clinical characteristics and outcome (ESGINI–04 study)Clinical Microbiology & Infection, 2001
- Recurrent urinary tract infection in womenInternational Journal of Antimicrobial Agents, 2001
- Relatedness ofEscherichia coliColonizing Women LongitudinallyMolecular Urology, 2001
- Ribotyping differentiates relapse from reinfection in the treatment failures of Escherichia coli urinary tract infections in childrenDiagnostic Microbiology and Infectious Disease, 1994
- Urinary Tract Infections in FemalesClinical Infectious Diseases, 1994
- Bacteriology and ultrastructure of the bladder in patients with urinary tract infectionsJournal of Infection, 1985
- The Influence of Long-term Treatment with Mecillinam on Fecal Escherichia coliScandinavian Journal of Infectious Diseases, 1984
- Studies of urinary tract infections in infancy and childhood: VIII. Reinfection vs. relapse in recurrent urinary tract infections. Evaluation by means of identification of infecting organismsThe Journal of Pediatrics, 1967
- Recurrent Infection of the Urinary Tract: Reinfection or Recrudescence?BMJ, 1966