An abbreviated MLVA identifies Escherichia coli ST131 as the major extended-spectrum β-lactamase-producing lineage in the Copenhagen area

Nielsen, Julius; Al-Bayati, Asseel; Jørgensen, Rikke Lind; Hansen, Katrine Hartung; Lundgren, Bettina; Schønning, Kristian

doi:10.1007/s10096-012-1764-x

Cited by 20 publications

(19 citation statements)

References 32 publications

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“…A similar fraction of ST131 among ESBL isolates was found in several international studies (24)(25)(26) and in a recent Danish study that, in contrast to our study, provided only limited characterization of the isolates (27).…”

Section: Discussionsupporting

confidence: 90%

Prevalence and Characteristics of the Epidemic Multiresistant Escherichia coli ST131 Clonal Group among Extended-Spectrum Beta-Lactamase-Producing E. coli Isolates in Copenhagen, Denmark

Olesen¹,

Hansen²,

Nilsson³

et al. 2013

J Clin Microbiol

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We report the characteristics of 115 extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli clinical isolates, from 115 unique Danish patients, over a 1-year study interval (1 October 2008 to 30 September 2009). Forty-four (38%) of the ESBL isolates represented sequence type 131 (ST13)1, from phylogenetic group B2. The remaining 71 isolates were from phylogenetic groups D (27%), A (22%), B1 (10%), and B2 (3%). Serogroup O25 ST131 isolates (n ‫؍‬ 42; 95% of ST131) comprised 7 different K antigens, whereas two ST131 isolates were O16:K100:H5. Compared to non-ST131 isolates, ST131 isolates were associated positively with CTX-M-15 and negatively with CTX-M-1 and CTX-M-14. They also were associated positively with 11 virulence genes, including afa and dra (Dr family adhesins), the F10 papA allele (P fimbria variant), fimH (type 1 fimbriae), fyuA (yersiniabactin receptor), iha (adhesin siderophore), iutA (aerobactin receptor), kpsM II (group 2 capsules), malX (pathogenicity island marker), ompT (outer membrane protease), sat (secreted autotransporter toxin), and usp (uropathogenicity-specific protein) and negatively with hra (heat-resistant agglutinin) and iroN (salmochelin receptor). The consensus virulence gene profile (>90% prevalence) of the ST131 isolates included fimH, fyuA, malX, and usp (100% each), ompT and the F10 papA allele (95% each), and kpsM II and iutA (93% each). ST131 isolates were also positively associated with community acquisition, extraintestinal pathogenic E. coli (ExPEC) status, and the O25, K100, and H4 antigens. Thus, among ESBL E. coli isolates in Copenhagen, ST131 was the most prevalent clonal group, was community associated, and exhibited distinctive and comparatively extensive virulence profiles, plus a greater variety of capsular antigens than reported previously. E scherichia coli is the most common agent of urinary tract infection (UTI) and Gram-negative bacteremia. E. coli sequence type 131 (ST131) is a recently emerged worldwide pandemic clonal group, causing widespread antimicrobial-resistant infections (1). Although many studies have examined various aspects of E. coli ST131 in diverse locales and clinical contexts (1, 2), little is known about ST131's O:K:H serotypes, especially in relation to community versus health care site of acquisition, coresistance phenotypes, extended-spectrum beta-lactamase (ESBL) variants, and pulse-field gel electrophoresis (PFGE) types. Such data are needed to more fully understand the epidemiology of ST131 and to help guide diagnostic and preventive efforts.CTX-M-type beta-lactamases have become the dominant ESBLs worldwide during the past decade (3). The responsible bla CTX-M genes are known to be associated with conjugative plasmids and certain successful bacterial clones, notably ST131 (4).Here we assessed the prevalence of E. coli ST131 among 115 consecutive ESBL-producing E. coli isolates from 115 patients (2008)(2009) from 3 hospitals and 100 general practitioners' offices in Copenhagen, Denmark. Subsequently, we compared ST131 and ...

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Section: Discussionsupporting

confidence: 90%

Prevalence and Characteristics of the Epidemic Multiresistant Escherichia coli ST131 Clonal Group among Extended-Spectrum Beta-Lactamase-Producing E. coli Isolates in Copenhagen, Denmark

Olesen¹,

Hansen²,

Nilsson³

et al. 2013

J Clin Microbiol

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“…Pheno-and genotypic characterizations were performed by using the MAST-test, PCR, and DNA sequence analysis according to methods used at the clinical laboratory of Department of Clinical Microbiology, Hvidovre Hospital, Denmark (HVH) or at Statens Serum Institut (SSI) as previously described (15). Sequence type verification was performed via full multilocus sequence typing (MLST, using the Achtmann scheme [http://mlst.warwick.ac.uk/mlst/dbs/Ecoli]) by SSI, who also found that the isolate harbored the virulence factors kpsM II and iutA (15)(16)(17).…”

Section: Strainmentioning

confidence: 99%

Antibiotic Selection of Escherichia coli Sequence Type 131 in a Mouse Intestinal Colonization Model

Hertz

Løbner-Olesen

Frimodt‐Møller

2014

Antimicrob Agents Chemother

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The ability of different antibiotics to select for extended-spectrum ␤-lactamase (ESBL)-producing Escherichia coli remains a topic of discussion. In a mouse intestinal colonization model, we evaluated the selective abilities of nine common antimicrobials (cefotaxime, cefuroxime, dicloxacillin, clindamycin, penicillin, ampicillin, meropenem, ciprofloxacin, and amdinocillin) against a CTX-M-15-producing E. coli sequence type 131 (ST131) isolate with a fluoroquinolone resistance phenotype. Mice (8 per group) were orogastrically administered 0.25 ml saline with 10 8 CFU/ml E. coli ST131. On that same day, antibiotic treatment was initiated and given subcutaneously once a day for three consecutive days. CFU of E. coli ST131, Bacteroides, and Gram-positive aerobic bacteria in fecal samples were studied, with intervals, until day 8. Bacteroides was used as an indicator organism for impact on the Gram-negative anaerobic population. For three antibiotics, prolonged colonization was investigated with additional fecal CFU counts determined on days 10 and 14 (cefotaxime, dicloxacillin, and clindamycin). Three antibiotics (cefotaxime, dicloxacillin, and clindamycin) promoted overgrowth of E. coli ST131 (P < 0.05). Of these, only clindamycin suppressed Bacteroides, while the remaining two antibiotics had no negative impact on Bacteroides or Gram-positive organisms. Only clindamycin treatment resulted in prolonged colonization. The remaining six antibiotics, including ciprofloxacin, did not promote overgrowth of E. coli ST131 (P > 0.95), nor did they suppress Bacteroides or Gram-positive organisms. The results showed that antimicrobials both with and without an impact on Gram-negative anaerobes can select for ESBL-producing E. coli, indicating that not only Gram-negative anaerobes have a role in upholding colonization resistance. Other, so-far-unknown bacterial populations must be of importance for preventing colonization by incoming E. coli.

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“…An abbreviated version of MLVA for the detection of E. coli ST131 that uses a benchtop capillary electrophoresis instrument was developed by Nielsen et al (167). The exclusion of two loci affected the discriminatory power of the abbreviated MLVA, making it less discriminatory than the original assay.…”

Section: Multilocus Variable-number Tandem-repeat Analysismentioning

confidence: 99%

The Role of Epidemic Resistance Plasmids and International High-Risk Clones in the Spread of Multidrug-Resistant Enterobacteriaceae

2015

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SUMMARY Escherichia coli sequence type 131 (ST131) and Klebsiella pneumoniae ST258 emerged in the 2000s as important human pathogens, have spread extensively throughout the world, and are responsible for the rapid increase in antimicrobial resistance among E. coli and K. pneumoniae strains, respectively. E. coli ST131 causes extraintestinal infections and is often fluoroquinolone resistant and associated with extended-spectrum β-lactamase production, especially CTX-M-15. K. pneumoniae ST258 causes urinary and respiratory tract infections and is associated with carbapenemases, most often KPC-2 and KPC-3. The most prevalent lineage within ST131 is named fimH30 because it contains the H30 variant of the type 1 fimbrial adhesin gene, and recent molecular studies have demonstrated that this lineage emerged in the early 2000s and was then followed by the rapid expansion of its sublineages H30-R and H30-Rx. K. pneumoniae ST258 comprises 2 distinct lineages, namely clade I and clade II. Moreover, it seems that ST258 is a hybrid clone that was created by a large recombination event between ST11 and ST442. Epidemic plasmids with bla CTX-M and bla KPC belonging to incompatibility group F have contributed significantly to the success of these clones. E. coli ST131 and K. pneumoniae ST258 are the quintessential examples of international multidrug-resistant high-risk clones.

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An abbreviated MLVA identifies Escherichia coli ST131 as the major extended-spectrum β-lactamase-producing lineage in the Copenhagen area

Cited by 20 publications

References 32 publications

Prevalence and Characteristics of the Epidemic Multiresistant Escherichia coli ST131 Clonal Group among Extended-Spectrum Beta-Lactamase-Producing E. coli Isolates in Copenhagen, Denmark

Prevalence and Characteristics of the Epidemic Multiresistant Escherichia coli ST131 Clonal Group among Extended-Spectrum Beta-Lactamase-Producing E. coli Isolates in Copenhagen, Denmark

Antibiotic Selection of Escherichia coli Sequence Type 131 in a Mouse Intestinal Colonization Model

The Role of Epidemic Resistance Plasmids and International High-Risk Clones in the Spread of Multidrug-Resistant Enterobacteriaceae

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