A Disseminated Multidrug-Resistant Clonal Group of Uropathogenic Escherichia Coli in Pyelonephritis

Lancet. 2002 Jun 29;359(9325):2249-51. doi: 10.1016/S0140-6736(02)09264-4.


In acute pyelonephritis, bacterial resistance to co-trimoxazole predicts treatment failure, but the clonal basis of such resistance is undefined. We did molecular and serological analyses of 170 Escherichia coli urine isolates obtained in 1994-96 from women with acute pyelonephritis. 12 (7%) of the pyelonephritis isolates were in clonal group A (CGA; responsible for 38-51% of co-trimoxazole resistance in acute cystitis), including ten (34%) of 29 isolates that were resistant to co-trimoxazole. CGA isolates were obtained from diverse locations across the USA and were related to the O15:K52:H1 clone of the 1986-87 outbreak in London, UK. Thus, CGA is broadly disseminated and contributes to co-trimoxazole resistance in pyelonephritis as well as in cystitis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Drug Resistance, Multiple, Bacterial / genetics*
  • Electrophoresis, Gel, Pulsed-Field
  • Escherichia coli / classification
  • Escherichia coli / drug effects*
  • Escherichia coli / pathogenicity
  • Female
  • Genotype
  • Humans
  • Polymerase Chain Reaction
  • Pyelonephritis / drug therapy*
  • Pyelonephritis / urine
  • Serotyping
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use*


  • Trimethoprim, Sulfamethoxazole Drug Combination