Professional paper
Escherichia coli – from commensal organism to multiply resistant uropathogen
Arjana Tambić Andrašević
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Anja Bukovac
; Geonatura d.o.o., Zagreb, Hrvatska
Marko Jelić
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Silvija Šoprek
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Marija Gužvinec
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Abstract
Escherichia coli is an integral part of gut microbiota but at the same time it is the most frequent causative agent of urinary tract infections (UTI). Numerous virulence factors are variably expressed in different strains. Several successful clones of extraintestinal pathogenic E. coli (exPEC) have spread worldwide. These clones are more prevalent among causative agents of cystitis and pyelonephritis than among fecal isolates in healthy humans and they express resistance to one or more antibiotics more often than sporadic clones. Trimethoprime- sulfamethoxazole was the first line antibiotic for the treatment of several UTI categories for a long time. Due to high rates of resistance that became apparent in the 1990s this antibiotic is no more recommended in empirical therapy of UTI in many parts of the world, including Croatia. Resistance to trimethoprime-sulfamethoxazole is over 20 % in Croatia and this did not change over the last ten years. In contrast, resistance to quinolones and beta-lactams shows increasing trend over the past ten year period. In 2011 Croatia switched from American to European sensitivity testing standards which slightly influenced resistance rates. E. coli can acquire various resistance mechanisms to a variety of antibiotics. Plasmid mediated resistance mechanisms are especially important because of the ease of horizontal gene exchange.
Keywords
E. coli; clonal spread; antibiotic resistance
Hrčak ID:
143362
URI
Publication date:
30.12.2014.
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