Temporal Trend of ST131 Clone among Urinary Escherichia coli Isolates in the Community: A Taiwan National Surveillance from 2002 to 2016

Sequence type (ST) 131 is a multidrug-resistant pandemic lineage of E. coli responsible for extraintestinal infections. Few surveillance data of ST131 included all antimicrobial-susceptible and -resistant isolates or focused on community-acquired urinary tract infection (UTI). From a population-based surveillance pool of 2997 outpatient urine E. coli isolates, 542 were selected for detection of ST131 based on ciprofloxacin and/or cefotaxime resistance. Pulsed-field gel electrophoresis (PFGE) was performed on all ST131 isolates to further determine their relatedness. The estimated overall ST131 prevalence in this community UTI cohort increased from 11.2% (in 2002–2004), 12.2% (in 2006–2008), 13.6% (in 2010–2012), to 17.4% in 2014–2016 (p < 0.01). In the ciprofloxacin-resistant/cefotaxime-resistant group, ST131 increased from 33.3% in 2002–2004 to 72.1% in 2014–2016 (p < 0.01). In the ciprofloxacin-resistant/cefotaxime-susceptible group, ST131 was found in 24.3% overall without significant increase in its prevalence over time. PFGE showed emergence of a cluster of ciprofloxacin-resistant/cefotaxime-resistant ST131 carrying Gr. 1 CTX-M ESBL in 2014–2016, especially 2016. Multivariate analysis revealed that age (≥65 y.o) and ciprofloxacin resistance were independent factors associated with ST131. This longitudinal surveillance showed that ciprofloxacin-resistant/cefotaxime-susceptible ST131 has been circulating in the community since 2002 but ciprofloxacin-resistant/cefotaxime-resistant ST131 increased rapidly in the later years.

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1432. Population-based Surveillance of Carbapenem-Resistant Enterobacteriaceae (CRE) in Alameda County, 2017-2020

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1614 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S721-S722

Author(s):

Sam Horwich-Scholefield ◽

Tyler Lloyd ◽

Vici Varghese ◽

Emily Yette ◽

Sandra Huang ◽

...

Keyword(s):

Public Health ◽

Klebsiella Pneumoniae ◽

Multidrug Resistant ◽

Population Based ◽

Sequence Type ◽

Alameda County ◽

E Coli ◽

Carbapenem Resistant ◽

Klebsiella Spp ◽

Carbapenem Resistant Enterobacteriaceae

Abstract Background Infections caused by carbapenem-resistant Enterobacteriaceae (CRE), especially those that are carbapenemase-producing (CP), are difficult to treat and result in high mortality— the Centers for Disease Control and Prevention (CDC) designates CRE an urgent level threat to public health. Alameda, a northern California county with 1.67 million residents, mandates submission of all carbapenem-resistant isolates Escherichia coli, Klebsiella spp., and Enterobacter spp. We assessed the genetic profiles of CRE isolates and compared to aggregate US data from the same time period. Methods Isolates are submitted to the Alameda County Public Health Laboratory (ACPHL), where antimicrobial resistance genetic markers are identified by whole genome sequencing (WGS) using single-end, 150-cycle reactions in a MiSeq (Illumina). Resistance genes were identified using pipelines built in Geneious and confirmed with Resfinder. All epidemiological analyses were conducted using R (Version 4.0). Results ACPHL performed WGS on 226 CRE isolates submitted between June 2017 and February 2020. A total of 34/95 (36%) Klebsiella spp., 17/60 (28%) E. coli, and 10/71 (14%) Enterobacter spp. a carbapenemase enzyme. Among all Enterobacteriaceae, 21/226 (9%) produced the New Delhi-metallo-β-lactamase (NDM) carbapenemase (Table 1). Among all CRE, 17/226 (8%) were Klebsiella pneumoniae with the multilocus sequence type (MLST) of ST-258. All six Klebsiella pneumoniae ST-35 and ST-11 isolates produced a carbapenemase (Table 2). Table 1: Carbapenemases, Extended Spectrum β-Lactamases (ESBL) and Other β-Lactamases by Organism Table 2: Organism, Multilocus Sequence Type (MLST) and Carbapenemases Present Conclusion Compared to US data, Alameda County Klebsiella spp. were nearly half as likely to produce any carbapenemase, and E. coli were three times more likely to produce an NDM carbapenemase. CP-CRE represented a wide array of MLST, with the globally distributed KPC-producing outbreak strain ST-258 being the most frequently identified. Two strains that have been associated with hypervirulent and multidrug resistant infections in Asia, K. pneumoniae ST-35 and ST-11, were also reported. Disclosures Sam Horwich-Scholefield, MPH CIC, Merck (Research Grant or Support)

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Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study

BMC Infectious Diseases ◽

10.1186/s12879-021-06326-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Melissa C. MacKinnon ◽

Scott A. McEwen ◽

David L. Pearl ◽

Outi Lyytikäinen ◽

Gunnar Jacobsson ◽

...

Keyword(s):

Escherichia Coli ◽

Mortality Rate ◽

Case Fatality ◽

Population Based ◽

Day Case ◽

Fatality Risk ◽

E Coli ◽

Factors Associated ◽

Case Fatality Risk ◽

Age And Sex

Abstract Background Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each. Methods During 2014–2018, we identified 30-day deaths from all incident E. coli BSIs from surveillance nationally in Finland, and regionally in Sweden (Skaraborg) and Canada (Calgary, Sherbrooke, western interior). We used a multivariable logistic regression model to estimate factors associated with 30-day case fatality risk. The explanatory variables considered for inclusion were year (2014–2018), region (five areas), age (< 70-years-old, ≥70-years-old), sex (female, male), third-generation cephalosporin (3GC) resistance (susceptible, resistant), and location of onset (community-onset, hospital-onset). The European Union 28-country 2018 population was used to directly age and sex standardize mortality rates. We used a multivariable Poisson model to estimate factors associated with mortality rate, and year, region, age and sex were considered for inclusion. Results From 38.7 million person-years of surveillance, we identified 2961 30-day deaths in 30,923 incident E. coli BSIs. The overall 30-day case fatality risk was 9.6% (2961/30923). Calgary, Skaraborg, and western interior had significantly increased odds of 30-day mortality compared to Finland. Hospital-onset and 3GC-resistant E. coli BSIs had significantly increased odds of mortality compared to community-onset and 3GC-susceptible. The significant association between age and odds of mortality varied with sex, and contrasts were used to interpret this interaction relationship. The overall standardized 30-day mortality rate was 8.5 deaths/100,000 person-years. Sherbrooke had a significantly lower 30-day mortality rate compared to Finland. Patients that were either ≥70-years-old or male both experienced significantly higher mortality rates than those < 70-years-old or female. Conclusions In our study populations, region, age, and sex were significantly associated with both 30-day case fatality risk and mortality rate. Additionally, 3GC resistance and location of onset were significantly associated with 30-day case fatality risk. Escherichia coli BSIs caused a considerable burden of disease from 30-day mortality. When analyzing population-based mortality data, it is important to explore mortality through two lenses, mortality rate and case fatality risk.

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Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli Isolated from Flies in the Urban Center of Berlin, Germany

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16091530 ◽

2019 ◽

Vol 16 (9) ◽

pp. 1530 ◽

Cited By ~ 3

Author(s):

Wibke Wetzker ◽

Yvonne Pfeifer ◽

Solvy Wolke ◽

Andrea Haselbeck ◽

Rasmus Leistner ◽

...

Keyword(s):

Escherichia Coli ◽

Continuous Monitoring ◽

Companion Animals ◽

Multidrug Resistant ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum ◽

Ciprofloxacin Resistance ◽

Multiple Pathogens

Background: The monitoring of antimicrobial resistance (AMR) in microorganisms that circulate in the environment is an important topic of scientific research and contributes to the development of action plans to combat the spread of multidrug-resistant (MDR) bacteria. As a synanthropic vector for multiple pathogens and a reservoir for AMR, flies can be used for surveillance. Methods: We collected 163 flies in the inner city of Berlin and examined them for extended-spectrum β-lactamase (ESBL)-producing Escherichia coli genotypically and phenotypically. Results: The prevalence of ESBL-producing E. coli in flies was 12.9%. Almost half (47.6%) of the ESBL-positive samples showed a co-resistance to ciprofloxacin. Resistance to carbapenems or colistin was not detected. The predominant ESBL-type was CTX-M-1, which is associated with wildlife, livestock, and companion animals as a potential major source of transmission of MDR E. coli to flies. Conclusions: This field study confirms the permanent presence of ESBL-producing E. coli in an urban fly population. For continuous monitoring of environmental contamination with multidrug-resistant (MDR) bacteria, flies can be used as indicators without much effort.

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Escherichia coli Sequence Type ST131 as an Emerging Fluoroquinolone-Resistant Uropathogen among Renal Transplant Recipients

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01089-09 ◽

2009 ◽

Vol 54 (1) ◽

pp. 546-550 ◽

Cited By ~ 52

Author(s):

James R. Johnson ◽

Brian Johnston ◽

Connie Clabots ◽

Michael A. Kuskowski ◽

Swaroop Pendyala ◽

...

Keyword(s):

Escherichia Coli ◽

Renal Transplant ◽

Multidrug Resistant ◽

Sequence Type ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Black Race ◽

E Coli ◽

Extended Spectrum

ABSTRACT Among 40 Escherichia coli urine isolates from renal transplant recipients (Galveston, TX, 2003 to 2005), sequence type ST131 (O25:H4) was highly prevalent (representing 35% of isolates overall and 60% of fluoroquinolone-resistant isolates), virulent appearing, antimicrobial resistant (but extended-spectrum-cephalosporin susceptible), and associated with black race. Pulsotypes were diverse; some were linked to other locales. ST131 emerged significantly during the study period. These findings suggest that E. coli ST131 may constitute an important new multidrug-resistant threat to renal transplant recipients.

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Activity of Ceftolozane-Tazobactam (C/T) against Escherichia coli Isolates from U.S. Veterans in Relation to Co-resistance and Sequence Type 131 (ST131) H30/H30Rx Status

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.921 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S374-S374

Author(s):

Brian D Johnston ◽

Paul Thuras ◽

James R Johnson

Keyword(s):

Significant Variation ◽

Multidrug Resistant ◽

Sequence Type ◽

Clinical Isolates ◽

The Novel ◽

Total Resistance ◽

Research Support ◽

E Coli ◽

The U.S ◽

Research Grant

Abstract Background E. coli ST131, with its resistance-associated H30 and H30Rx clonal subsets, causes most antimicrobial-resistant E. coli infections, especially among veterans. The activity of the novel combination agent C/T against ST131 is undefined. Methods E. coli clinical isolates (n = 595), including (per VAMC) 10 each ciprofloxacin-resistant and susceptible isolates, plus archived ESBL isolates, were collected from 24 VAMCs across the U.S. (2011). ST131, H30, and H30Rx were detected by clonal PCR. Microdilution MICs were determined for C/T and 5 comparators (piperacillin-tazobactam [TZP], levofloxacin [LVX], gentamicin [GEN], ceftazidime [CAZ], and meropenem [MEM]). Categorical resistance and MICs were compared statistically with resistance category and H30/H30Rx status. Results Total resistance prevalence was < 5% for C/T (3.5%) and MEM (0%), vs. from 7.9% (TZP) to 59% (LVX) for other comparators (Table 1). Resistance prevalence generally increased by resistance category from FQ-S through FQ-R to ESBL, and by clonal subgroup from non-H30 through H30 to H30Rx. Conclusion C/T is broadly active against E. coli clinical isolates from veterans, notwithstanding significant variation by resistance category and ST131-H30/H30Rx status; it outperformed all non-carbapenem comparators. C/T should prove useful as a carbapenem-sparing agent against multidrug-resistant E. coli ST131 infections. Disclosures B. D. Johnston, Merck Sharpe & Dohme, Corp.: Collaborator, Research support Actavis: Collaborator, Research support; J. R. Johnson, Merck: Grant Investigator, Research grant Grant Investigator, Research grant

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Initial Assessment of the Molecular Epidemiology ofblaNDM-1in Colombia

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.03072-15 ◽

2016 ◽

Vol 60 (7) ◽

pp. 4346-4350 ◽

Cited By ~ 14

Author(s):

Laura J. Rojas ◽

Meredith S. Wright ◽

Elsa De La Cadena ◽

Gabriel Motoa ◽

Kristine M. Hujer ◽

...

Keyword(s):

Hot Spot ◽

Multidrug Resistant ◽

Sequence Type ◽

Initial Assessment ◽

Genome Sequences ◽

Gram Negative ◽

Content Type ◽

E Coli ◽

Resistance Determinants ◽

Novel Complex

ABSTRACTWe report complete genome sequences of fourblaNDM-1-harboring Gram-negative multidrug-resistant (MDR) isolates from Colombia. TheblaNDM-1genes were located on 193-kb Inc FIA, 178-kb Inc A/C2, and 47-kb (unknown Inc type) plasmids. Multilocus sequence typing (MLST) revealed that these isolates belong to sequence type 10 (ST10) (Escherichia coli), ST392 (Klebsiella pneumoniae), and ST322 and ST464 (Acinetobacter baumanniiandAcinetobacter nosocomialis, respectively). Our analysis identified that the Inc A/C2 plasmid inE. colicontained a novel complex transposon (Tn125and Tn5393with three copies ofblaNDM-1) and a recombination “hot spot” for the acquisition of new resistance determinants.

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Long-Term Care Facilities Are Reservoirs for Antimicrobial-Resistant Sequence Type 131 Escherichia coli

Open Forum Infectious Diseases ◽

10.1093/ofid/ofv011 ◽

2015 ◽

Vol 2 (1) ◽

Cited By ~ 25

Author(s):

Mary J. Burgess ◽

James R. Johnson ◽

Stephen B. Porter ◽

Brian Johnston ◽

Connie Clabots ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Gel Electrophoresis ◽

Long Term Care ◽

Pulsed Field Gel Electrophoresis ◽

Sequence Type ◽

Term Care ◽

E Coli ◽

Care Facilities

Abstract Background. Emerging data implicate long-term care facilities (LTCFs) as reservoirs of fluoroquinolone-resistant (FQ-R) Escherichia coli of sequence type 131 (ST131). We screened for ST131 among LTCF residents, characterized isolates molecularly, and identified risk factors for colonization. Methods. We conducted a cross-sectional study using a single perianal swab or stool sample per resident in 2 LTCFs in Olmsted County, Minnesota, from April to July 2013. Confirmed FQ-R E. coli isolates underwent polymerase chain reaction-based phylotyping, detection of ST131 and its H30 and H30-Rx subclones, extended virulence genotyping, and pulsed-field gel electrophoresis (PFGE) analysis. Epidemiological data were collected from medical records. Results. Of 133 fecal samples, 33 (25%) yielded FQ-R E. coli, 32 (97%) of which were ST131. The overall proportion with ST131 intestinal colonization was 32 of 133 (24%), which differed by facility: 17 of 41 (42%) in facility 1 vs 15 of 92 (16%) in facility 2 (P = .002). All ST131 isolates represented the H30 subclone, with virulence gene and PFGE profiles resembling those of previously described ST131 clinical isolates. By PFGE, certain isolates clustered both within and across LTCFs. Multivariable predictors of ST131 colonization included inability to sign consent (odds ratio [OR], 4.16 [P = .005]), decubitus ulcer (OR, 4.87 [ P = .04]), and fecal incontinence (OR, 2.59 [P = .06]). Conclusions. Approximately one fourth of LTCF residents carried FQ-R ST131 E. coli resembling ST131 clinical isolates. Pulsed-field gel electrophoresis suggested intra- and interfacility transmission. The identified risk factors suggest that LTCF residents who require increased nursing care are at greatest risk for ST131 colonization, possibly due to healthcare-associated transmission.

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Genotype Analysis of Escherichia coliStrains Isolated from Children and Chickens Living in Close Contact

Applied and Environmental Microbiology ◽

10.1128/aem.65.2.472-476.1999 ◽

1999 ◽

Vol 65 (2) ◽

pp. 472-476 ◽

Cited By ~ 31

Author(s):

S. Kariuki ◽

C. Gilks ◽

J. Kimari ◽

A. Obanda ◽

J. Muyodi ◽

...

Keyword(s):

Gel Electrophoresis ◽

Genomic Dna ◽

Genetic Relatedness ◽

Close Contact ◽

Multidrug Resistant ◽

Pulsed Field Gel Electrophoresis ◽

Pfge Analysis ◽

E Coli ◽

Susceptibility Profiles ◽

Endonuclease Digestion

ABSTRACT Escherichia coli isolates from rectal swabs from 62 chickens and stools from 42 children living in close contact with chickens on the same farms in Kiambu district, Kenya, were compared for their genetic relatedness. Antibiotic susceptibility profiles broadly categorized isolates from the children and from the chickens into two separate clusters: the majority (144; 85.5%) of the E. coli isolates from children were multidrug resistant, while the majority (216; 87.1%) of the E. coli isolates from chickens were either fully susceptible or resistant only to tetracycline. Sixty- and 100- to 110-MDA plasmids were found to encode the transferable resistance to co-trimoxazole and tetracycline.HindIII restriction endonuclease digestion of the 60- and 100- to 110-MDA plasmids produced four distinct patterns for isolates from children and three distinct patterns for isolates from chickens.XbaI digestion of genomic DNA followed by pulsed-field gel electrophoresis (PFGE) analysis produced 14 distinct clusters. There were six distinct PFGE clusters among the isolates from children, while among the isolates from chickens there were seven distinct clusters. Only one PFGE cluster contained isolates from both children and chickens, with the isolates displaying an approximately 60% coefficient of similarity. This study showed that although several different genotypes of E. coli were isolated from children and chickens from the same farms, the E. colistrains from these two sources were distinct.

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Draft Genomic Sequences of Three Escherichia coli Sequence Type 131 Isolates (H45, H43ii, and H43iii) from Patients in Lagos, Nigeria

Microbiology Resource Announcements ◽

10.1128/mra.00076-20 ◽

2020 ◽

Vol 9 (17) ◽

Author(s):

Yishan Yang ◽

Christopher H. Sommers ◽

Eyitayo O. Adenipekun ◽

Marina Ceruso ◽

Charlene R. Jackson ◽

...

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Bloodstream Infections ◽

Multidrug Resistant ◽

Sequence Type ◽

Urine Samples ◽

Genomic Sequences ◽

Content Type ◽

E Coli

Escherichia coli sequence type 131 (ST131) has recently emerged as a leading multidrug-resistant pathogen that causes urinary tract and bloodstream infections in humans. Here, we report the draft genomic sequences of three E. coli ST131 isolates, H45, H43ii, and H43iii, from urine samples of patients in Lagos, Nigeria.

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Characterization of Salmonella enterica Isolates from Diseased Poultry in Northern China between 2014 and 2018

Pathogens ◽

10.3390/pathogens9020095 ◽

2020 ◽

Vol 9 (2) ◽

pp. 95 ◽

Cited By ~ 4

Author(s):

Jun Wang ◽

Jinxin Li ◽

Fengli Liu ◽

Yongyou Cheng ◽

Jingliang Su

Keyword(s):

Broiler Chicken ◽

Northern China ◽

Pulsed Field Gel Electrophoresis ◽

Sequence Type ◽

Salmonella Infection ◽

Salmonella Spp ◽

Factors Associated ◽

First Time ◽

Meat Type

Salmonella infection not only causes acute and chronic diseases in poultry flocks, but the infected poultry are among the most important reservoirs for a variety of Salmonella serovars frequently transmitted to humans. This study aimed to investigate the occurrence of Salmonella spp. in local poultry farms in China. Samples (n = 4255), including dead-in-shell embryos, culled day-old-hatchings and 1- to 4-week-old diseased birds, were collected for Salmonella culture from broiler chicken, meat-type duck and pigeon farms in northern China between 2014 and 2018. A total of 103 Salmonella were isolated. S. enterica serovar Enteritidis and S. Typhimurium were the most prevalent serovars, representing 53.4% and 34.9% of the isolates, respectively. Serovar diversity was the highest in ducks, with the S. Apeyeme being isolated for the first time from duck tissues. All isolates were characterized by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). MLST showed that all S. Enteritidis isolates shared the same sequence type (ST11), and Typhimurium showed several rare STs in addition to ST19. In comparison, PFGE showed better discrimination for S. Enteritidis and S. Typhimurium isolates, with nine distinct pulsotypes being observed. The isolates exhibited varying degrees of resistance to 15 tested antimicrobials and identified S. Enteritidis isolates (98.18%) with multiple antimicrobial resistance were a cause for concern. Our data on invasive Salmonella infection in meat-type poultry in local farms can be used to identify sources and factors associated with Salmonella spread in poultry and the associated food chain.

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