There are many pathogenic species of ecoli. The use of PCR has allowed the differentiation of these organisms in stool specimens. The following article discusses Enteroinvasive E. coli (EIEC).
https://www.asm.org/Articles/2019/March/Whats-the-Significance-of-Enteroinvasive-E-coli
There are many species of E. ecoli. Although Shiga toxin (Stx)-producing E. coli is associated with GI related illnesses, this organism has been seen as a cause of UTI which is demonstrated in the article below.
- Toval F, Schiller R, Meisen I, et al. Characterization of Urinary Tract Infection-Associated Shiga Toxin-Producing Escherichia coli. Payne SM, ed. Infect Immun. Published online August 25, 2014:4631-4642. doi:10.1128/iai.01701-14
MecA is typically seen with Staphylococcus which confers resistance to methicillin subsequently resulting in MRSA. However, MecA has also been detected with other bacteria. The following article addressed MecA resistance genes in non Staphylococcus bacteria.
- Kassem II, Esseili MA, Sigler V. Occurrence of mecA in Nonstaphylococcal Pathogens in Surface Waters. Journal of Clinical Microbiology. Published online September 24, 2008:3868-3869. doi:10.1128/jcm.01035-08
MecA expressed by Staphylococcus causes resistance to oxacillin/methicillin resulting in methicillin-resistant Staphylococcus aureus (MRSA). This happens when isolates produce an altered penicillin-binding protein, PBP2a, encoded by the mecA gene. The following article discusses MRSA and what antibiotics are ineffective.
- https://www.cdc.gov/mrsa/lab/index.html. https://www.cdc.gov/mrsa/lab/index.html. https://www.cdc.gov/mrsa/lab/index.html
https://www.cdc.gov/mrsa/lab/index.html
Choosing the right drug may still lead to failure in eradicating the infection if the appropriate dose is not administered. Bactrim can often be difficult to dose especially in the setting of kidney disease. The following article addresses dose adjustments for Bactrim.
Drug summary published by PDR (Prescribers Digital Reference)
https://www.pdr.net/drug-summary/Bactrim-Bactrim-DS-sulfamethoxazole-trimethoprim-686
There are many ways in which microbes become resistant. Understanding the mechanism of resistance is important as treatment may change consequently. The following article reviews the mechanisms of resistance.
- van H, Mevius D, Guerra B, Mullany P, Roberts A, Aarts H. Acquired antibiotic resistance genes: an overview. Front Microbiol. 2011;2:203. doi:10.3389/fmicb.2011.00203
As PCR becomes more accessible to healthcare providers, understanding how the impact of resistance genes on treatment options is essential. The following article addresses resistance genes and how antibiotic therapy may need modification as a result.
- Munita J, Arias C. Mechanisms of Antibiotic Resistance. Microbiol Spectr. 2016;4(2). doi:10.1128/microbiolspec.VMBF-0016-2015
Candida is commonly found in urine specimens. However, this does not mean that treatment is required. Candida is part of the normal flora and therefore can be isolated in healthy individuals. However, there are situations when treatment is required.
- Behzadi P, Behzadi E, Ranjbar R. Urinary tract infections and Candida albicans. Cent European J Urol. 2015;68(1):96-101. doi:10.5173/ceju.2015.01.474