Molecular epidemiological analysis of Escherichia coli sequence type ST131 (O25:H4) and blaCTX-M-15 among extended-spectrum-β-lactamase-producing E. coli from the United States, 2000 to 2009 - PubMed (original) (raw)

Multicenter Study

. 2012 May;56(5):2364-70.

doi: 10.1128/AAC.05824-11. Epub 2012 Feb 21.

Carl Urban, Scott J Weissman, James H Jorgensen, James S Lewis 2nd, Glen Hansen, Paul H Edelstein, Ari Robicsek, Timothy Cleary, Javier Adachi, David Paterson, John Quinn, Nancy D Hanson, Brian D Johnston, Connie Clabots, Michael A Kuskowski; AMERECUS Investigators

Collaborators, Affiliations

Multicenter Study

Molecular epidemiological analysis of Escherichia coli sequence type ST131 (O25:H4) and blaCTX-M-15 among extended-spectrum-β-lactamase-producing E. coli from the United States, 2000 to 2009

James R Johnson et al. Antimicrob Agents Chemother. 2012 May.

Abstract

Escherichia coli sequence type ST131 (from phylogenetic group B2), often carrying the extended-spectrum-β-lactamase (ESBL) gene bla(CTX-M-15), is an emerging globally disseminated pathogen that has received comparatively little attention in the United States. Accordingly, a convenience sample of 351 ESBL-producing E. coli isolates from 15 U.S. centers (collected in 2000 to 2009) underwent PCR-based phylotyping and detection of ST131 and bla(CTX-M-15). A total of 200 isolates, comprising 4 groups of 50 isolates each that were (i) bla(CTX-M-15) negative non-ST131, (ii) bla(CTX-M-15) positive non-ST131, (iii) bla(CTX-M-15) negative ST131, or (iv) bla(CTX-M-15) positive ST131, also underwent virulence genotyping, antimicrobial susceptibility testing, and pulsed-field gel electrophoresis (PFGE). Overall, 201 (57%) isolates exhibited bla(CTX-M-15), whereas 165 (47%) were ST131. ST131 accounted for 56% of bla(CTX-M-15)-positive- versus 35% of bla(CTX-M-15)-negative isolates (P < 0.001). Whereas ST131 accounted for 94% of the 175 total group B2 isolates, non-ST131 isolates were phylogenetically distributed by bla(CTX-M-15) status, with groups A (bla(CTX-M-15)-positive isolates) and D (bla(CTX-M-15)-negative isolates) predominating. Both bla(CTX-M-15) and ST131 occurred at all participating centers, were recovered from children and adults, increased significantly in prevalence post-2003, and were associated with molecularly inferred virulence. Compared with non-ST131 isolates, ST131 isolates had higher virulence scores, distinctive virulence profiles, and more-homogeneous PFGE profiles. bla(CTX-M-15) was associated with extensive antimicrobial resistance and ST131 with fluoroquinolone resistance. Thus, E. coli ST131 and bla(CTX-M-15) are emergent, widely distributed, and predominant among ESBL-positive E. coli strains in the United States, among children and adults alike. Enhanced virulence and antimicrobial resistance have likely promoted the epidemiological success of these emerging public health threats.

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Figures

Fig 1

Fig 1

Principal coordinate analysis of virulence genotype data (upper panel) and antimicrobial resistance data (lower panel) among 200 Escherichia coli isolates (collected in 2000 to 2009) in relation to ST131 and _bla_CTX-M-15 status. Populations 1 to 4 correspond to the groups shown in the tables (i.e., Table 1, non-ST131 _bla_CTX-M-15 negative; Table 2, non-ST131 _bla_CTX-M-15 positive; Table 3, ST131 _bla_CTX-M-15 negative; Table 4, ST131 _bla_CTX-M-15 positive). Upper panel (virulence genotypes): coordinates 1 and 2 capture 58% and 12% of total variation, respectively. Note the marked separation of (overlapping) populations 1 and 2 from (overlapping) populations 3 and 4. Lower panel (antimicrobial resistance): coordinates 1 and 2 capture 32% and 26% of total variation, respectively. Note the marked overlap of all four populations.

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