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Antimicrobial Agents and Chemotherapy, January 2005, p. 26-31, Vol. 49, No. 1
0066-4804/05/$08.00+0     doi:10.1128/AAC.49.1.26-31.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Virulence Genotype and Phylogenetic Origin in Relation to Antibiotic Resistance Profile among Escherichia coli Urine Sample Isolates from Israeli Women with Acute Uncomplicated Cystitis

James R. Johnson,1,2* Michael A. Kuskowski,3,4 Timothy T. O'Bryan,1,2 Raul Colodner,5 and Raul Raz6,7

Medical Service,1 Geriatric Research, Education, and Clinical Center, Minneapolis VA Medical Center,3 Departments of Medicine,2 Psychiatry, University of Minnesota, Minneapolis, Minnesota,4 Microbiology Laboratory,5 Infectious Diseases Unit, HaEmek Medical Center,6 Technion School of Medicine, Afula, Israel7

Received 10 May 2004/ Returned for modification 16 August 2004/ Accepted 12 September 2004

To clarify the virulence and phylogenetic implications of antimicrobial agent resistance in Escherichia coli, 100 E. coli isolates from urine samples of Israeli women with acute uncomplicated cystitis were analyzed by molecular phylotyping and virulence genotyping for comparison with resistance phenotypes. The differences between the isolates that were resistant and susceptible to trimethoprim-sulfamethoxazole and ampicillin were minimal. In contrast, ciprofloxacin resistance was associated with greatly reduced inferred virulence and categorical shifts away from the highly virulent phylogenetic group B2, which explained much of the virulence effect. The results of amplification fingerprinting suggested that most ciprofloxacin-resistant isolates represented unique clonal groups and were not derived from clonal groups with more highly virulent susceptible isolates. These findings suggest that virulence and antimicrobial resistance are not mutually exclusive in E. coli clinical isolates. Instead, the relationship between virulence and antimicrobial resistance varies according to the particular resistance phenotype; for ciprofloxacin resistance, the relationship is strongly influenced by phylogenetic background. The basis for the concentration of ciprofloxacin resistance in non-B2 phylogenetic groups remains unknown.

* Corresponding author. Mailing address: Infectious Diseases (111F), Minneapolis VA Medical Center, One Veterans Dr., Minneapolis, MN 55417. Phone: (612) 467-4185. Fax: (612) 727-5995. E-mail: johns007{at}umn.edu.

Antimicrobial Agents and Chemotherapy, January 2005, p. 26-31, Vol. 49, No. 1
0066-4804/05/$08.00+0     doi:10.1128/AAC.49.1.26-31.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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