scholarly journals Genotyping of Escherichia coli Causing Vaginal Infection in Dysplastic Patients with Similar Genetic Backgrounds Between Commensal and Virulent Strains

2021 ◽  
Vol 14 (10) ◽  
Author(s):  
Clemente Cruz-Cruz ◽  
Emilio Mariano Durán-Manuel ◽  
Laura Delgado-Balbuena ◽  
Juan Carlos Bravata-Alcántara ◽  
Laura Margarita Márquez-Valdelamar ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Virulence Genes ◽  
Cervical Dysplasia ◽  
Variable Region ◽  
Vaginal Infection ◽  
Great Resistance ◽  
E Coli ◽  
Virulent Strains ◽  
Class 1 ◽  
Immunosuppressed Patients

Background: Escherichia coli in the vagina includes several virulence factors in its genome mobile genetic elements and can facilitate colonization, mainly in immunosuppressed patients. Objectives: This work aimed to demonstrate that E. coli strains of vaginal origin isolated from dysplastic patients possess virulence and resistance genes Methods: This study included one hundred and five E. coli strains isolated from women with cervical dysplasia and vaginal infection. The strains were characterized by antimicrobial susceptibility. The Clermont algorithm performed the phylogenetic assignment. The structure of class 1 integrons was performed by identifying integrase (int1), the variable region, and qacEΔ1-sul1 genes. The variable region was amplified, sequenced, and analyzed. Enterobacterial repetitive intergenic consensus (ERIC) PCR and virus typing typed strains with identical genetic arrangements by detecting virulence genes related to cytotoxicity, adherence, and iron uptake. Results: Escherichia coli strains showed great resistance to β-lactams and quinolones, and phylogenetic assignment showed that the group A/C was highly predominant. Sixteen integrons were identified, with monogenic arrays represented by aadA1, dfrB4dfrA7, dfr2D, and dfrA17 cassettes. The prevalence of the biogenic arrays aadA1/dfrA1 and aadA5/dfrA17 was lower than that of blaOXA-1/aadA1. Concerning virulence genes, fimH, traT, and iutA were the most predominant. Conclusions: The high incidence of virulence and resistance factors in commensal and virulent strains of E. coli revealed potential tools in the pathogenesis of vaginal infection.

scholarly journals Molecular characterisation of antimicrobial resistance and virulence genes in Escherichia coli strains isolated from diarrhoeic and healthy rabbits in Tunisia

2020 ◽  
Vol 28 (2) ◽  
pp. 81
Author(s):  
Raouia Ben Rhouma ◽  
Ahlem Jouini ◽  
Amira Klibi ◽  
Safa Hamrouni ◽  
Aziza Boubaker ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Virulence Genes ◽  
Antimicrobial Agents ◽  
Antibiotic Resistance Genes ◽  
Virulence Gene ◽  
Diffusion Method ◽  
Class 1 Integron ◽  
E Coli ◽  
Class 1

The purpose of this study was to identify <em>Escherichia coli</em> isolates in diarrhoeic and healthy rabbits in Tunisia and characterise their virulence and antibiotic resistance genes. In the 2014-2015 period, 60 faecal samples from diarrhoeic and healthy rabbits were collected from different breeding farms in Tunisia. Susceptibility to 14 antimicrobial agents was tested by disc diffusion method and the mechanisms of gene resistance were evaluated using polymerase chain reaction and sequencing methods. Forty <em>E. coli</em> isolates were recovered in selective media. High frequency of resistance to tetracycline (95%) was detected, followed by different levels of resistance to sulphonamide (72.5%), streptomycin (62.5%), trimethoprim-sulfamethoxazole (60%), nalidixic acid (32.5%), ampicillin (37.5%) and ticarcillin (35%). <em>E. coli</em> strains were susceptible to cefotaxime, ceftazidime and imipenem. Different variants of bla<sub>TEM</sub>, <em>tet</em>, <em>sul</em> genes were detected in most of the strains resistant to ampicillin, tetracycline and sulphonamide, respectively. The presence of class 1 integron was studied in 29 sulphonamide-resistant <em>E. coli</em> strains from which 15 harboured class 1 integron with four different arrangements of gene cassettes, <em>dfrA17</em>+<em>aadA5</em> (n=9), <em>dfrA1</em> + <em>aadA1</em> (n=4), <em>dfrA12</em> + <em>addA2</em> (n=1), <em>dfrA12</em>+<em>orf</em>+<em>addA2</em> (n=1). The <em>qnrB</em> gene was detected in six strains out of 13 quinolone-resistant <em>E. coli</em> strains. Seventeen <em>E. coli</em> isolates from diarrhoeic rabbits harboured the enteropathogenic eae genes associated with different virulence genes tested (<em>fimA</em>, <em>cnf1</em>, <em>aer</em>), and affiliated to B2 (n=8) and D (n=9) phylogroups. Isolated <em>E. coli</em> strains from healthy rabbit were harbouring <em>fim A</em> and/or <em>cnf1</em> genes and affiliated to A and B1 phylogroups. This study showed that <em>E. coli</em> strains from the intestinal tract of rabbits are resistant to the widely prescribed antibiotics in medicine. Therefore, they constitute a reservoir of antimicrobial-resistant genes, which may play a significant role in the spread of antimicrobial resistance. In addition, the eae virulence gene seemed to be implicated in diarrhoea in breeder rabbits in Tunisia.

scholarly journals Relationship between Escherichia coli strains causing urinary tract infection in women and the dominant faecal flora of the same hosts

2006 ◽  
Vol 134 (5) ◽  
pp. 1015-1023 ◽  
Author(s):  
E. MORENO ◽  
A. ANDREU ◽  
T. PÉREZ ◽  
M. SABATÉ ◽  
J. R. JOHNSON ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Virulence Genes ◽  
Virulence Gene ◽  
Faecal Flora ◽  
E Coli ◽  
Virulent Strains ◽  
Faecal Samples

To clarify whether prevalence or special pathogenicity is more important in determining urinary tract infection (UTI) causation, we compared the biotype, phylogenetic group, and virulence genes of Escherichia coli urine strains from 11 women with acute lower UTI with those of the host's dominant intestinal E. coli strain(s). Twenty-one unique E. coli clones were identified. For three women, the single faecal clone identified was also the host's urine clone, whereas for eight women faecal samples yielded 1 or 2 distinct non-urine clones (total, n=10), either with (n=3) or without (n=5) the concurrent urine clone. The eight urine clones from the latter eight women exhibited significantly greater inferred virulence, according to virulence gene content and phylogenetic background, than did the hosts' 10 corresponding ‘faecal only’ clones. In contrast, the three urine clones that were detected as the host's sole faecal clone exhibited significantly lower inferred virulence than the other eight urine clones, and were statistically indistinguishable from the 10 ‘faecal only’ clones. In conclusion, special pathogenicity is an important determinant of UTI pathogenesis in women, although prevalence may occasionally allow less virulent strains to cause UTI.

scholarly journals Diverse Escherichia coli pathovars of phylogroups B2 and D isolated from animals in Tunisia

2017 ◽  
Vol 11 (07) ◽  
pp. 549-556 ◽  
Author(s):  
Hajer Kilani ◽  
Mohamed Salah Abbassi ◽  
Sana Ferjani ◽  
Rakia Ben Salem ◽  
Riadh Mansouri ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Polymerase Chain Reaction ◽  
Antibiotic Resistance ◽  
Virulence Genes ◽  
Chain Reaction ◽  
E Coli ◽  
Class 1 ◽  
Genes Encoding ◽  
Polymerase Chain ◽  
Relationship Of

Introduction: The virulent Escherichia coli strains responsible for extraintestinal infections were mainly belonged to B2 and D phylogroups. However, no past studies have determinate via the presence of virulence genes the frequency of E. coli pathovars recovered from animals housed in farms in Tunisia. The aims of this study were to investigate 26 E. coli isolated from healthy and diarrheic animals and to determinate via the presence of virulence genes the frequency of pathovars. Methodology: Twenty-six E. coli isolates of phylogroups B2 (n = 14), B22 (n = 9), B23 (n = 5), and D2 (n = 12) were characterized. Genes encoding virulence factors (fimH,eaeA,aggC,papC, papG allele III, hlyA, east1, cnf1, exhA,stx1, stx2, iutA, fyuA, ibeA,and ipaH), and antibiotic resistance as well as class 1 and 2 integrons were searched by polymerase chain reaction (PCR). The genetic relationship of isolates was done by PFGE. Results: According to the occurrence of specific genes the 26 isolates were classified as:9 EAEC, 2 EHEC, 4 UPEC, 3 EPEC/EHEC and 1 NTEC. Therefore, 2 Ex-PEC and 5 APEC were presented amongst our strains. Some isolates (12) were clonal and the remaining was unrelated. Conclusions: Higher diversity of pathovars which carried diverse combinations of virulence genes in healthy isolates. In addition, it seems that the infections were caused by different mechanisms.

Antibiotic Resistance and Virulence Genes in Commensal Escherichia coli and Salmonella Isolates from Commercial Broiler Chicken Farms†

2007 ◽  
Vol 70 (6) ◽  
pp. 1316-1327 ◽  
Author(s):  
FATOUMATA DIARRASSOUBA ◽  
MOUSSA SORY DIARRA ◽  
SUSAN BACH ◽  
PASCAL DELAQUIS ◽  
JANE PRITCHARD ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Broiler Chicken ◽  
Virulence Genes ◽  
Antimicrobial Agents ◽  
Growth Promotion ◽  
Tetracycline Resistance ◽  
E Coli ◽  
Class 1 ◽  
Commercial Broiler

Antibiotic resistance patterns and the presence of antibiotic and virulence determinants in 74 sorbitol-negative Escherichia coli and 62 Salmonella isolates from nine different broiler chicken farms were investigated. Each farm was supplied by one of three companies that used different antimicrobial agents in feed for growth promotion. The isolates were identified by API 20E for E. coli and by serological tests for Salmonella. The susceptibility of the isolates to antibiotics was determined by Sensititre using the Clinical and Laboratory Standards Institute's breakpoints. Fifty-two E. coli isolates (70.3%) and nine Salmonella isolates (14.52%) were multiresistant to at least nine antibiotics. The multiresistant isolates were evaluated for the presence of tetracycline resistance, integron class 1, and blaCMY-2 genes by PCR. Of the 74 E. coli isolates, 55 were resistant to amoxicillin and ceftiofur. Among these 55 resistant E. coli isolates, 45 (81.8%) and 22 (40.0%) were positive for blaCMY-2 and qacEΔ1-SulI genes, respectively. Tetracycline resistance was found in 56 isolates (75.8%) among which 12 (21.4%) and 24 (42.9%) gave positive results for tetA and tetB, respectively. Virulence genes (iss, tsh, and traT ), aerobactin operon (iucC), and the eaeA gene were detected in some E. coli strains. Among the 27 amoxicillin- and ceftiofur-resistant Salmonella isolates, the blaCMY-2 gene was detected in 22 isolates. The class 1 integron gene (qacEΔ1-SulI) was not detected in any Salmonella isolates, whereas the invasin (inv) and virulence (spv) genes were found in 61 (98.4%) and 26 (42%) of the Salmonella isolates, respectively. This study indicated that multiple antibiotic-resistant commensal E. coli and Salmonella strains carrying virulence genes can be found on commercial broiler chicken farms and may provide a reservoir for these genes in chicken production facilities. Except for the presence of tetB, there was no significant effect of feed formulations on the phenotypic or genotypic characteristics of the isolates.

scholarly journals The Resistome, Mobilome, Virulome and Phylogenomics of Multidrug-Resistant Escherichia coli Clinical Isolates from Pretoria, South Africa

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Nontombi Marylucy Mbelle ◽  
Charles Feldman ◽  
John Osei Sekyere ◽  
Nontuthuko Excellent Maningi ◽  
Lesedi Modipane ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
South Africa ◽  
Virulence Genes ◽  
Clinical Epidemiology ◽  
Multidrug Resistant ◽  
Antibiotic Resistant ◽  
E Coli ◽  
Class 1 ◽  
Animal Strains ◽  
Plasmid Replicons

Abstract Antibiotic-resistant Escherichia coli is a common occurrence in food, clinical, community and environmental settings worldwide. The resistome, mobilome, virulome and phylogenomics of 20 multidrug resistant (MDR) clinical E. coli isolates collected in 2013 from Pretoria, South Africa, were characterised. The isolates were all extended-spectrum β-lactamase producers, harbouring CTX-M (n = 16; 80%), TEM-1B (n = 10; 50%) and OXA (n = 12, 60%) β-lactamases alongside genes mediating resistance to fluoroquinolones, aminoglycosides, tetracyclines etc. Most resistance determinants were found on contigs containing IncF plasmid replicons and bracketed by composite transposons (Tn3), diverse ISs and class 1 integrons (In13, In54, In369, and In467). Gene cassettes such as blaOXA,dfrA5-psp-aadA2-cmlA1a-aadA1-qac and estX3-psp-aadA2-cmlA1a-aadA1a-qac were encompassed by Tn3 and ISs; several isolates had same or highly similar genomic antibiotic resistance islands. ST131 (n = 10), ST617 (n = 2) and singletons of ST10, ST73, ST95, ST410, ST648, ST665, ST744 and ST998 clones were phylogenetically related to clinical (human and animal) strains from Egypt, Kenya, Niger, Nigeria, Tanzania, and UK. A rich repertoire of virulence genes, including iss, gad and iha were identified. MDR E. coli harbouring chromosomal and plasmid-borne resistance genes in same and multiple clones exist in South Africa, which is very worrying for clinical epidemiology and infectious diseases management.

First Detection of CTX-M-1 in Extended-Spectrum β-Lactamase–Producing Escherichia coli in Seafood from Tunisia

2017 ◽  
Vol 80 (11) ◽  
pp. 1877-1881 ◽  
Author(s):  
Leila Ben Said ◽  
Mouna Hamdaoui ◽  
Ahlem Jouini ◽  
Abdellatif Boudabous ◽  
Karim Ben Slama ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Virulence Genes ◽  
Diffusion Method ◽  
Carriage Rate ◽  
Disk Diffusion Method ◽  
Class 1 Integron ◽  
E Coli ◽  
Extended Spectrum ◽  
Class 1

ABSTRACT The purpose of this study was to determine the carriage rate of Escherichia coli isolates in seafood, to analyze the phenotype and genotype of antimicrobial resistance in the recovered isolates, and to characterize extended-spectrum β-lactamase (ESBL) E. coli producers. E. coli isolates were recovered from 24 (34.3%) of the 70 seafood samples analyzed, and one isolate per sample was further characterized. Antibiotic resistance was determined by the disk diffusion method in the 24 isolates, with the following results (number of resistant isolates): tetracycline (8), streptomycin (7), ampicillin (6), trimethoprim-sulfamethoxazole (4), chloramphenicol (4), ciprofloxacin (3), cefotaxime (2), and ceftazidime (2). Six isolates showed a multiresistant phenotype (including at least three families of antibiotics). Among tetracycline-resistant E. coli isolates, tet(A) was detected in five isolates and tet(B) in two isolates. The qnr(A) or aac(6′)-1b-cr genes were detected in two ciprofloxacin-resistant E. coli isolates, and the sul2 gene in two trimethoprim-sulfamethoxazole–resistant isolates. ESBL-containing E. coli isolates, carrying the blaCTX-M-1 gene, were detected in 2 of the 70 seafood samples, obtained from gilt-head bream aquaculture. The ESBL isolates were typed phylogenetically and by multilocus sequence typing, and they were ascribed to lineage ST48/A and to the new ST3497/B1; these isolates carried the fimA, aer, and papGIII virulence genes. One of the ESBL-producing E. coli isolates carried an unusual class 1 integron (with the array dfr32-ereA-aadA1). Seafood could be a source of multiresistant E. coli isolates for the aquatic environment, and these could enter the food chain.

Molecular Characterization of Multidrug-Resistant Escherichia coli Isolates from Edible Offal in Korea

2019 ◽  
Vol 82 (7) ◽  
pp. 1183-1190
Author(s):  
SE HYUN SON ◽  
KWANG WON SEO ◽  
YEONG BIN KIM ◽  
HYE YOUNG JEON ◽  
EUN BI NOH ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Virulence Genes ◽  
Antimicrobial Agents ◽  
Food Product ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
E Coli ◽  
Antimicrobial Resistance Genes ◽  
Class 1

ABSTRACT Edible offal, which is the nonmuscular part of the livestock, is a popular food product in many countries. However, it can be easily contaminated by bacteria, such as Escherichia coli, during slaughter and processing and regarded as a reservoir for transfer of antimicrobial-resistant bacteria to humans. This study aimed to investigate prevalence and characteristics of antimicrobial-resistant E. coli isolates from edible offal in Korea. A total of 320 chicken offal samples, 540 pig offal samples, and 560 cattle offal samples were collected. Among the 118 E. coli isolates obtained, resistance to at least one antimicrobial agent was revealed in 32 (100%), 46 (95.8%), and 26 (68.4%) isolates of chicken, pig, and cattle offals, respectively, with an overall prevalence of 88.1% (104 of 118). The isolates from chicken offal showed highest resistance to most antimicrobial agents, with the exception of higher ampicillin resistance for isolates from pig offal. In the distribution of antimicrobial resistance genes of 69 (58.5%) multidrug-resistant (MDR) E. coli, blaTEM-1 (97.1%), tetA (76.6%), sul2 (70.6%), and cmlA (57.4%) were most prevalent. Class 1 and class 2 integrons were detected in 82.6 and 2.9% of the MDR isolates, respectively. In total, seven virulence genes (eaeA, escV, astA, fimH, papC, sfa/focDE, and iucC) were also identified in the MDR isolates. The fimH gene was the most frequent (91.3%). Overall, 52 isolates from chicken (24 isolates, 96.0%), pig (16 isolates, 55.2%) and cattle (12 isolates, 80.0%) offals among MDR isolates were found to have some plasmid replicons. Frep (38 isolates) and FIB (27 isolates) replicons were more prevalent than other replicon types. The results suggest that edible offal can become a relevant reservoir of E. coli strains carrying various antimicrobial resistance and virulence genes. HIGHLIGHTS

scholarly journals Virulence genes and antimicrobial susceptibility of Escherichia coli taken from women with vaginitis in Talca, Chile

2014 ◽  
Vol 8 (03) ◽  
pp. 265-270 ◽  
Author(s):  
Carlos Padilla ◽  
Andrés Padilla ◽  
Olga Lobos
Keyword(s):  
Escherichia Coli ◽  
High Resistance ◽  
Antimicrobial Susceptibility ◽  
Virulence Genes ◽  
Diagnosis And Treatment ◽  
Aetiological Agent ◽  
Vaginal Infection ◽  
E Coli ◽  
Antibacterial Susceptibility

Introduction: Vaginitis is one of the most common reasons women visit a gynecologist. Escherichia coli has been isolated from women with vaginitis, but its role as a vaginal infection aetiological agent is controversial. This study aimed to detect virulence genes and determine the antimicrobial susceptibility of E. coli strains isolated from monomicrobial and polymicrobial cultures collected from women with  vaginitis. Methodology: The presence of the following virulence genes: papC, hly, iucC, afa, fimH, neuC, sfa/foc, cnf1, usp, and ibeA in two E. coli groups was determined by PCR. The antibacterial susceptibility of strains was tested. Results: A higher percentage (93.3%) of isolated strains from monomicrobial cultures with virulence genes in relation to  polymicrobial cultures (56.7%) was found. The most frequent virulence genes in both groups were hly (p = 0.0357), fimH (p = 0.000), and cfn1 (p = 0.000). In addition, E. coli isolated from monomicrobial cultures showed 5 genetic combinations compared to the 10 observed in the polymicrobial cultures. An increased number of strains were sensitive to cefotaxime, moxifloxacin, and ciprofloxacin. A high resistance to trimethoprim-sulfamethoxazole was observed. Conclusions: Most of the E. coli strains isolated from monomicrobial cultures and some from polymicrobial cultures showed virulence genes. A better understanding of  the virulence and antibacterial susceptibility of E. coli strains isolated from patients with vaginitis can contribute to improved diagnosis and treatment of this disease.

scholarly journals Determination of Antibiotic Resistance Profile and Virulence Genes in Escherichia coli Isolates from Palestinian Patients

2019 ◽  
pp. 1-9
Author(s):  
Ghaleb Adwan
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Virulence Factors ◽  
High Resistance ◽  
Virulence Genes ◽  
Resistance Rate ◽  
E Coli ◽  
Different Types ◽  
Class 1

Introduction: Escherichia coli (E. coli) is considered one of the most frequent intestinal and extraintestinal pathogen. Methods:  A total of 49 isolates of E. coli were collected from different clinical samples, from different hospitals in Northern West Bank-Palestine, during January-March 2019. Aims: To detect the distribution of Type III secretion system (T3SS) genes, class 1, 2 and 3 integrons, virulence factors (fyuA, papGIII, iutA and sfa⁄foc) using multiplex PCR and antibiotic resistance using disc diffusion method. Results: In this study, E. coli isolates showed high resistance rate against different types of antibiotics and 71.4% of the isolates were multidrug resistant (MDR). Only class 1 integron was detected in these isolates with prevalence 57%, and 65.7% of MDR isolates carried integron genes. The prevalence of T3SS genes was 0.0%. In addition, results of this study showed that the prevalence of virulence genes papGIII, sfa⁄foc, fyuA and iutA was 4.1%, 40%, 64%, and 79.6%, respectively. Conclusions: The isolates of E. coli showed high resistance rate against different types of antibiotics. The co-occurrence of class 1 integrons and antimicrobial resistance genes in these isolates is an additional threat for spread of the antimicrobial resistance traits which may further complicate future strategies for treatment the infections caused by this pathogen. In addition, E. coli isolated from Palestinian patients showed one or more virulence factors that could increase their pathogenic potential.

scholarly journals Commensal and virulent Escherichia coli strains of vaginal origin are reservoirs of resistance cassettes in class 1 integrons

2020 ◽  
Vol 14 (01) ◽  
pp. 48-58 ◽  
Author(s):  
Manalli Itzahaya Blancarte–Lagunas ◽  
Graciela Castro-Escarpulli ◽  
Armando Navarro-Ocaña ◽  
Gabriela Ibáñez-Cervantes ◽  
Laura Margarita Marquez-Valdelamar ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Structural Diversity ◽  
Gene Cassette ◽  
Vaginal Infection ◽  
Aerobic Vaginitis ◽  
E Coli ◽  
Class 1 Integrons ◽  
Class 1 ◽  
Dihydrofolate Reductases ◽  
Group A

Introduction: Antimicrobial resistance in Escherichia coli, one of the causal agents of aerobic vaginitis, leads to the persistence of the infection. The investigation of integrons acquires relevance, since they are elements that are responsible for the acquisition of resistance to antibiotics. The aim of this work was to describe the structural diversity of class 1 integrons in virulent and commensal strains of E. coli isolated from patients with vaginal infection. Methodology: Ninety-two strains of E. coli were isolated from patients with aerobic vaginitis. Resistance profile against 19 antibiotics and class 1 integrons were detected by PCR. The identity and arrangement of cassettes was determined by sequencing. ERIC-PCR assays were carried out in strains with identical arrays. Finally, genotyping by Clermont algorithm and serotyping were performed. Seventeen strains showed integrons located in plasmids. Results: Ten different gene cassette arrays were identified in 30 strains of E. coli. Cassettes corresponding to genes coding for adenylyltransferases (aadA), dihydrofolate reductases (dfrA), and oxacillinases (blaOXA) were detected. Array dfrA17-aadA5 was predominantly prevalent over the other arrays identified. Phylogenetic group A was the most predominant, followed by group B2 and D. Conclusions: This study demonstrates the presence of E. coli of vaginal origin carrying class 1 integrons, which are main genetic elements of capture of resistance genes, with the possibility of capturing new resistance cassettes. These evidences should serve for the modification of protocols in the diagnosis and treatment of aerobic vaginitis, and the development of policies for the rational use of antimicrobials.

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