Antibiotic resistance and small R plasmids among Escherichia coli isolates from outpatient urinary tract infections in northern Norway

Abstract

Escherichia coli strains from outpatient urinary tract infections in northern Norway over a period of 1 year were examined for resistance to nine commonly used antibiotics. Strains collected during 4.5 months were examined for R plasmid content by using conjugation and in vitro transformation. Of the E. coli strains, 42% were resistant to one or more antibiotics. Resistance was highest to sulfonamide (20.8% of all strains), nitrofurantoin (14.5%), and tetracycline (10.1%), whereas less than 6% of the strains were resistant to ampicillin, carbenicillin, cephalothin, nalidixic acid, or trimethoprim-sulfamethoxazole. No strain was resistant to gentamicin. Tetracycline resistance was more common in men than in women. Resistance to cephalothin, nalidixic acid, and sulfonamide was higher in strains from older people. Resistance to sulfonamide was more frequent in the urban community. These was no seasonal variation in antibiotic resistance, although the incidence of urinary tract infection varied with seasons. Plasmid-determined resistance to ampicillin, streptomycin, sulfonamide, and tetracycline was found. About 18% of the resistant strains from the urban municipality carried R plasmids, most of which were small plasmids mediating resistance to sulfonamide and streptomycin. The overall frequency of resistance in strains collected from rural areas was similar to the urban frequency, but in the rural strains, R plasmids were found in only 5% of the resistant strains.