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Isolation of thymidine-dependent and extended-spectrum-β-lactamase-producing Escherichia coli small-colony variant from urine of a septuagenarian female patient with recurrent cystitis: A case report with genetic investigation.
J Infect Chemother. 2020 Jun 19 [Online ahead of print]JI

Abstract

Thymidine-dependent small-colony variant (TD-SCV) of Escherichia coli was isolated from urine of a septuagenarian female patient on hemodialysis suffering from recurrent cystitis. The patient had been treated with frequent administrations of trimethoprim sulfamethoxazole (SXT), every time her cystitis symptoms developed. In the TD-SCV isolate, the deletion was detected in the thyA gene associated with thymidylate synthase. Interestingly, the isolate was found to produce extended-spectrum β-lactamase (ESBL), and the experiment on conjugational transfer of the resistance trait was successful. By means of genetic analysis, the isolate was found to carry blaCTX-M-1 group. To the best of our knowledge, this is the first report of urinary tract infection caused by the transmissible ESBL-producing TD-SCV of E. coli. MICs of the TD-SCV were obtained only on the Mueller Hinton agar media supplemented with appropriate concentrations of thymidine, which might lead to the difficulty for proper chemotherapy in daily medicine. Furthermore, transmission of the ESBL gene via plasmid should be of concern.

Authors+Show Affiliations

Department of Clinical Laboratory, Kansai Medical University Medical Center, Moriguchi, 570-8507, Japan.Division of Infection Control and Microbiological Regulation, Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto, 390-8621, Japan; Division of Clinical Microbiology, Department of Biomedical Laboratory Sciences, School of Health Sciences, Shinshu University School of Medicine, Matsumoto, 390-8621, Japan. Electronic address: yk23724@shinshu-u.ac.jp.Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, 371-8514, Japan.Laboratory of Bacterial Drug Resistance, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan.Department of Clinical Laboratory, Kansai Medical University Medical Center, Moriguchi, 570-8507, Japan.Department of Clinical Laboratory, Kansai Medical University Medical Center, Moriguchi, 570-8507, Japan.Department of Clinical Laboratory, Kansai Medical University Medical Center, Moriguchi, 570-8507, Japan.Department of Clinical Laboratory, Kansai Medical University Medical Center, Moriguchi, 570-8507, Japan.Department of Clinical Laboratory, Kansai Medical University Medical Center, Moriguchi, 570-8507, Japan.Department of Clinical Laboratory, Kansai Medical University Medical Center, Moriguchi, 570-8507, Japan.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32571646

Citation

Nagano, Natsumi, et al. "Isolation of Thymidine-dependent and Extended-spectrum-β-lactamase-producing Escherichia Coli Small-colony Variant From Urine of a Septuagenarian Female Patient With Recurrent Cystitis: a Case Report With Genetic Investigation." Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy, 2020.
Nagano N, Kawakami Y, Matsumoto T, et al. Isolation of thymidine-dependent and extended-spectrum-β-lactamase-producing Escherichia coli small-colony variant from urine of a septuagenarian female patient with recurrent cystitis: A case report with genetic investigation. J Infect Chemother. 2020.
Nagano, N., Kawakami, Y., Matsumoto, T., Tanimoto, K., Kashihara, M., Nagata, M., Honjyo, H., Yamamoto, K., Takada, A., & Sugiura, T. (2020). Isolation of thymidine-dependent and extended-spectrum-β-lactamase-producing Escherichia coli small-colony variant from urine of a septuagenarian female patient with recurrent cystitis: A case report with genetic investigation. Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy. https://doi.org/10.1016/j.jiac.2020.05.013
Nagano N, et al. Isolation of Thymidine-dependent and Extended-spectrum-β-lactamase-producing Escherichia Coli Small-colony Variant From Urine of a Septuagenarian Female Patient With Recurrent Cystitis: a Case Report With Genetic Investigation. J Infect Chemother. 2020 Jun 19; PubMed PMID: 32571646.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Isolation of thymidine-dependent and extended-spectrum-β-lactamase-producing Escherichia coli small-colony variant from urine of a septuagenarian female patient with recurrent cystitis: A case report with genetic investigation. AU - Nagano,Natsumi, AU - Kawakami,Yoshiyuki, AU - Matsumoto,Takehisa, AU - Tanimoto,Koichi, AU - Kashihara,Masami, AU - Nagata,Megumi, AU - Honjyo,Hideyasu, AU - Yamamoto,Konosuke, AU - Takada,Atsuaki, AU - Sugiura,Tetsuro, Y1 - 2020/06/19/ PY - 2019/11/25/received PY - 2020/04/30/revised PY - 2020/05/16/accepted PY - 2020/6/24/entrez KW - E. coli KW - ESBL KW - SCV KW - Small-colony variant KW - Thymidine-dependent JF - Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy JO - J. Infect. Chemother. N2 - Thymidine-dependent small-colony variant (TD-SCV) of Escherichia coli was isolated from urine of a septuagenarian female patient on hemodialysis suffering from recurrent cystitis. The patient had been treated with frequent administrations of trimethoprim sulfamethoxazole (SXT), every time her cystitis symptoms developed. In the TD-SCV isolate, the deletion was detected in the thyA gene associated with thymidylate synthase. Interestingly, the isolate was found to produce extended-spectrum β-lactamase (ESBL), and the experiment on conjugational transfer of the resistance trait was successful. By means of genetic analysis, the isolate was found to carry blaCTX-M-1 group. To the best of our knowledge, this is the first report of urinary tract infection caused by the transmissible ESBL-producing TD-SCV of E. coli. MICs of the TD-SCV were obtained only on the Mueller Hinton agar media supplemented with appropriate concentrations of thymidine, which might lead to the difficulty for proper chemotherapy in daily medicine. Furthermore, transmission of the ESBL gene via plasmid should be of concern. SN - 1437-7780 UR - https://www.unboundmedicine.com/medline/citation/32571646/Isolation_of_thymidine-dependent_and_extended-spectrum-β-lactamase-producing_Escherichia_coli_small-colony_variant_from_urine_of_a_septuagenarian_female_patient_with_recurrent_cystitis:_A_case_report_with_genetic_investigation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1341-321X(20)30171-9 DB - PRIME DP - Unbound Medicine ER -
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