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Journal of Antimicrobial Chemotherapy (2002) 49, 373-377
© 2002 The British Society for Antimicrobial Chemotherapy

Brief report

Pyelonephritis caused by multiple clones of Escherichia coli, susceptible and resistant to co-amoxiclav, after a 45 day course of co-amoxiclav

Véronique Leflon-Guibouta, Stéphane Bonacorsib, Olivier Clermontb, Géraldine Ternata, Beate Heyma and Marie-Hélène Nicolas-Chanoinea,*

a Service de Microbiologie, Hôpital Ambroise Paré (AP-HP), Faculté de Médecine Paris-Ouest, Université Paris V, Boulogne; b Service de Microbiologie, Laboratoire d'Etudes de Génétique Bactérienne dans les Infections de l'Enfant EA 3105, Hôpital Robert Debré, Paris, France

Objectives: We studied the clonal relatedness, in terms of phylogenetic group, virulence factors and co-amoxiclav resistance, of different Escherichia coli isolates obtained from blood and urine of a patient who had taken a 45 day course of co-amoxiclav.

Patients and methods: The isolates were typed by molecular methods, and the virulence and resistance genes studied by PCR.

Results: The four phenotypically different E. coli isolates were classified into four clones and two phylogenetic groups (B2 and A), and displayed different virulence gene patterns. The two isolates resistant to co-amoxiclav were phylogenetically and clonally different, and harboured two different blaTEM genes.

Conclusion: These two blaTEM genes did not derive from each other following a mutant selection process in vivo.

* Correspondence address. Service de Microbiologie, Hôpital A. Paré, 9 avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France. Tel: +33-1-49-09-55-40; Fax: +33-1-49-09-59-21; E-mail: marie-helene.nicolas-chanoine{at}apr.ap-hop-paris.fr


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