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Objectives: The aim of this study was to assess the clonal structure, virulence potential and antibiotic susceptibility of uropathogenic Escherichia coli (UPEC) isolates causing community acquired urinary tract infection (CAUTI) in unselected primary care patients in Switzerland. Methods: We performed multilocus sequence typing, virulence factor determination, and phenotypic and genotypic antimicrobial resistance testing on 44 non-duplicate UPEC isolates. Results: Twenty-seven different sequence types (STs) were identified. Major UPEC clones were represented by 19 (43.2%) of the isolates, including E. coli ST131, ST69 (both 13.6%), ST73 (6.8%), ST10 (4.5%), ST127, ST140, (both 2.3%). Five (11.4%) isolates belonged to ST141. Aggregate virulence factor (VF) scores were highest among isolates belonging to ST127 and ST141. Overall, 50% of the isolates were susceptible to all 12 antimicrobials tested, and all isolates remained susceptible to fosfomycin and nitrofurantoin. Resistance to sulfamethoxazole and ciprofloxacin were found in 31.8, and 15.9% of the isolates, respectively. Plasmid-mediated resistance genes were detected in ST69 and ST131 and included aac(6')-Ib-cr (2.3% of all isolates) blaCTX-M-14 and blaCTX-M-15 (9%), and mph(A) (13.6%). None of the isolates tested positive for mcr-1 or mcr-2. Conclusions: Our results show that CAUTI in Switzerland is caused by a wide variety of UPEC STs for which fosfomycin remains a good treatment option. We suggest that ST141 is an emerging clone associated with UTI in the community, and warrants closer attention. Moreover, the high rate of E. coli harboring mph(A) from patients without a history of antimicrobial therapy or hospitalization indicates that UPEC is an important reservoir for mph(A).

Chromobacterium violaceum is an opportunistic pathogen in humans. Nearly 150 cases have been reported worldwide. The usual presentation is with an initial localized skin lesion and progression to multiple liver and lung abscesses and finally fatal septicemia. Progression is usually seen in immunocompromised individuals or when appropriate antimicrobial therapy was delayed. Mortality ranges up to 60% if not promptly treated. A 73-year-old male presented with febrile urinary tract infection (UTI). His urine culture grew C. violaceum. Neither was he immunocompromised nor was he having any risk factor for this infection. He was not admitted in any hospital in the recent past. He did not have any urological intervention in the past. He was treated successfully with culture sensitive antibiotics. He responded well and he continues to be asymptomatic at 6 months of follow-up. The incidence of UTI by C. violaceum is on the rise. Only three cases of UTI caused by C. violaceum have been reported so far worldwide. This is the second case of symptomatic UTI caused by C. violaceum from the Indian subcontinent. The early recognition of this infection and prompt treatment with appropriate antibiotic go a long way in the prevention of sepsis and its associated morbidity.