{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T01:15:44Z","timestamp":1793927744555,"version":"4.8.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Microbiol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Although urinary tract infections (UTIs) are extremely common, isolation of causative uropathogens is not always routinely performed, with antibiotics frequently prescribed empirically. This study determined the susceptibility of urinary isolates from two Health and Social Care Trusts (HSCTs) in Northern Ireland to a range of antibiotics commonly used in the treatment of UTIs. Furthermore, we determined if detection of trimethoprim resistance genes (\n                      <jats:italic>dfrA<\/jats:italic>\n                      ) could be used as a potential biomarker for rapid detection of phenotypic trimethoprim resistance in urinary pathogens and from urine without culture.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Susceptibility of\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp. isolates (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u2009124) to trimethoprim, amoxicillin, ceftazidime, ciprofloxacin, co-amoxiclav and nitrofurantoin in addition to susceptibility of\n                      <jats:italic>Proteus mirabilis<\/jats:italic>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u200961) and\n                      <jats:italic>Staphylococcus saprophyticus<\/jats:italic>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u200917) to trimethoprim was determined by ETEST\u00ae and interpreted according to EUCAST breakpoints. PCR was used to detect\n                      <jats:italic>dfrA<\/jats:italic>\n                      genes in bacterial isolates (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u2009202) and urine samples(\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u200994).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Resistance to trimethoprim was observed in 37\/124 (29.8%)\n                      <jats:italic>E. coli and Klebsiella<\/jats:italic>\n                      spp. isolates with an MIC\n                      <jats:sub>90<\/jats:sub>\n                      \u00a0&gt;\u200932\u2009mg\/L.\n                      <jats:italic>DfrA<\/jats:italic>\n                      genes were detected in 29\/37 (78.4%) trimethoprim-resistant isolates. Detection of\n                      <jats:italic>dfrA<\/jats:italic>\n                      was highly sensitive (93.6%) and specific (91.4%) in predicting phenotypic trimethoprim resistance among\n                      <jats:italic>E. coli and Klebsiella<\/jats:italic>\n                      spp. isolates. The\n                      <jats:italic>dfrA<\/jats:italic>\n                      genes analysed were detected using a culture-independent PCR method in 16\/94 (17%) urine samples. Phenotypic trimethoprim resistance was apparent in isolates cultured from 15\/16 (94%)\n                      <jats:italic>dfrA<\/jats:italic>\n                      -positive urine samples. There was a significant association (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u20090.0001) between the presence of\n                      <jats:italic>dfrA<\/jats:italic>\n                      and trimethoprim resistance in urine samples containing Gram-negative bacteria (Sensitivity\u2009=\u200975%; Specificity\u2009=\u200996.9%; PPV\u2009=\u200993.8%; NPV\u2009=\u200986.1%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This study demonstrates that molecular detection of\n                      <jats:italic>dfrA<\/jats:italic>\n                      genes is a good indicator of trimethoprim resistance without the need for culture and susceptibility testing.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12866-022-02551-9","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:04:24Z","timestamp":1653350664000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Antimicrobial resistance in urinary pathogens and culture-independent detection of trimethoprim resistance in urine from patients with urinary tract infection"],"prefix":"10.1186","volume":"22","author":[{"given":"Yinka M.","family":"Somorin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichola-Jane M.","family":"Weir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally H.","family":"Pattison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin A.","family":"Crockard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmel M.","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Tunney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre F.","family":"Gilpin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,24]]},"reference":[{"key":"2551_CR1","doi-asserted-by":"crossref","unstructured":"Pouwels KB, Dolk FCK, Smith DRM, Robotham JV, Smieszek T. 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Consent was not required for urine samples as they were surplus samples collected after routine urinalysis.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"MA Crockard was an employee of Randox Laboratories Ltd. (Northern Ireland), a manufacturer of molecular diagnostic tests. All other authors are working in collaboration with Randox Laboratories Ltd. (Northern Ireland).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"144"}}