Sharing of virulent Escherichia coli clones among household members of a woman with acute cystitis.
ABSTRACT Within-household transmission of extraintestinal pathogenic Escherichia coli (ExPEC) may contribute to the pathogenesis of urinary tract infection (UTI), but this is poorly understood.
A woman with acute UTI, 4 human household members who cohabited with her, and the family's pet dog underwent prospective longitudinal surveillance for colonizing E. coli for 7-9 weeks after the woman's UTI episode. Unique clones were resolved by random amplified polymorphic DNA and pulsed-field gel electrophoresis analysis. Virulence genes, phylogenetic group, and O types were defined by PCR. Comparisons with reference strains were made using random amplified polymorphic DNA profiling.
Serial fecal and urine samples from the 6 household members yielded 7 unique E. coli clones (4 of which were ExPEC and 3 of which were non-ExPEC). For 3 clones, extensive among-host sharing was evident in patterns suggesting host-to-host transmission. The mother's UTI clone, which represented E. coli O1:K1:H7, was the clone that was most extensively shared (in 5 hosts, including the dog) and most frequently recovered (in 45% of samples and at all 3 time points). The other 3 ExPEC clones corresponded with E. coli O6:K2:H1, O1:K1:H7, and O2:F10,F48.
E. coli clones, including ExPEC, can be extensively shared among human and animal household members in the absence of sexual contact and in patterns suggesting host-to-host transmission.
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ABSTRACT: INTRODUCTION AND HYPOTHESIS: Recurrent urinary tract infections (UTIs) are more common in women and are frequently defined as ≥2 episodes in the last 6 months or ≥3 episodes in the last 12 months. In a primary care setting, 53 % of women above the age of 55 years and 36 % of younger women report a recurrence within 1 year. Thus, management and prevention of recurrent UTI is of utmost significance. This review aims to highlight the latest research in prevention strategies and suggest a management pathway. METHODS: A search was conducted on MEDLINE, Embase and the Cochrane Database of Systematic Reviews databases for the latest systematic reviews and high-quality randomized controlled trials. Special emphasis was placed on the remit "recurrent" and strongly adhered to. Furthermore, a Google search was conducted for current guidelines on the management of UTIs. RESULTS: Current prevention strategies include eliminating risk factors that increase the risk of acquiring recurrent UTI and continuous, post-coital and self-initiated antimicrobial prophylaxis. Other prospective preventative strategies, currently under trial, include use of vaccinations, D-mannose and lactobacillus (probiotics). CONCLUSION: Although risk factors should be identified and addressed accordingly, individualized antibiotic prophylaxis remains the most effective method of management. Non-antibiotic prevention strategies such as cranberry, vitamin C and methenamine salts lack strong evidence to be introduced as routine management options and as alternatives to antibiotics. Based on current evidence and guidelines, a management pathway is recommended. Emerging therapies require further evaluation before they can be recommended.International Urogynecology Journal 10/2014; · 2.16 Impact Factor
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ABSTRACT: Study was carried out on 96 swabs of uterine discharge of bitches with a history of infertility and repeat breeding irrespective of their age or breed, received in College Central Laboratory. On bacteriological examination, 92 (95.83%) were found positive for bacterial growth yielding 120 isolates. Of these positive samples, 65 (70.65%) yielded single bacterial species, 26 (28.26%) yielded two species, and the remaining 1 (1.08%) yielded 3 different bacterial species. Of 120 isolates, Streptococcus pyogenes was the predominant organism accounting for 55 (45.83%) infections followed by Staphylococcus aureus 23 (19.16%), Escherichia coli 20 (16.66%), Corynebacterium pyogenes 19 (15.83%), Pseudomonas aeruginosa 2 (1.67%) and Klebseilla pneumoniae 1(0.83%). Most common mixed infection was of S. aureus + S. pyogenes (11) and S. pyogenes + C. pyogenes (7) followed by other combinations S. pyogenes + E. coli (3), C. pyogenes+ E. coli (2), S. aureus + S. pyogenes + C. pyogenes (1), P. aeruginosa + S. pyogenes (1), E. coli + K. pneumoniae (1), S. aureus + C. pyogenes (1). Overall antimicrobial sensitivity pattern revealed that majority of the isolates were highly sensitive (80.20 to 89.58%) for azithromycin, norfloxacin, ceftriaxone, cephaperazone and clindamycin. Whereas 77.08 to 79.16% bacterial isolates were moderately sensitive towards oxytetracycline, chloramphenicol, ciprofloxacin, erythromycin, gentamicin, amoxycillin, carbenicillin. Least sensitivity (44.79 to 72.91%) towards isolates were shown by penicillin, streptomycin, ampicillin, neomycin, cloxacillin, enrofloxacin, amoxyclav, co-trimaxole, cephalexin. Therefore, for rational use of antibiotics, prior testing of antibiotic sensitivity is suggested.Journal of comparative microbiology, immunology and infectious diseases. 07/2014; Volume 35(Number 1):22-25.
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ABSTRACT: Background: Extraintestinal infections caused by multidrug-resistant (MDR) Escherichia coli and Enterobacter are becoming more common in veterinary medicine.Objective: To generate hypotheses for risk factors for dogs acquiring extraintestinal infection caused by MDR E. coli and Enterobacter, describe antimicrobial resistance profiles and analyze treatment and clinical outcomes.Animals: Thirty-seven dogs diagnosed with extraintestinal infection caused by MDR E. coli and Enterobacter spp. between October 1999 and June 2006.Methods: Retrospective case series assembled from hospital records data, including clinical history before 1st MDR isolation and treatment outcome. Identity and antimicrobial susceptibility profiles were confirmed by standard microbiological techniques for 57 isolates.Results: Most dogs had an underlying disease condition (97%), received prior antimicrobial treatment (87%), were hospitalized for ≥3 days (82%), and had a surgical intervention (57%). The urinary tract was the most common infection site (62%), and urinary catheterization, bladder stasis, or both were common among dogs (24%). Some dogs were treated with high doses of co-amoxyclavulanate (n = 14) and subsequently recovered even though the isolates showed in vitro resistance to this antimicrobial. Other dogs were successfully treated with chloramphenicol (n = 11) and imipenem (n = 2).Conclusion and Clinical Importance: Predisposing disease condition, any prior antimicrobial use rather than a specific class of antimicrobial, duration of hospitalization, and type of surgical procedure might be risk factors for acquiring MDR extraintestinal infections. Whereas culture and sensitivity results can indicate use of last-resort antimicrobials such as imipenem for MDR infections, some affected dogs can recover after administration of high doses of co-amoxyclavulanate.Journal of Veterinary Internal Medicine 07/2008; 22(4). · 2.06 Impact Factor