<i>Escherichia coli</i>Sequence Type ST131 as the Major Cause of Serious Multidrug‐Resistant<i>E. coli</i>Infections in the United States

Johnson, James R.; Johnston, Brian; Clabots, Connie; Kuskowski, Michael A.; Castanheira, Mariana

doi:10.1086/653932

Cited by 448 publications

(267 citation statements)

References 29 publications

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“…Resistance problem is now recognized as having a prominent clonal component attributable to the emergence and dissemination of specific antibiotic resistant clonal group of ExPEC ( (Johnson et al, 2010). The report of the clonal group of UPEC in pregnant women with UTI in this study is unique and appears to be the first of its kind in the study areas.…”

Section: Discussionmentioning

confidence: 70%

Phenotypic Identification and Phylogenetic Characterization of Uropathogenic Escherichia coli in Symptomatic Pregnant Women With Urinary Tract Infections in South-Western Nigeria

Abiodun¹,

Olufunke²,

Dunah³

et al. 2014

IJB

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The study reports the characterization of uropathogenic E. coli (UPEC) in urine samples of pregnant women with confirmed urinary tract infections (UTIs) in Ondo and Ekiti States, Nigeria.Voided mid-stream urine samples were cultured on eosin methylene blue agar plates at 37 o C and identified by conventional biochemical tests. Antibiotic susceptibility testing of isolates was by Kirby-Bauer's disc diffusion technique. Phylogenetic typing of the isolates was by multiplex polymerase chain reaction (PCR).The occurrence of UPEC in pregnant women in age group 25-35 years (66.0%) was high. Two hundred and sixty four uropathogenic E. coli comprising 133 (50.38%) in Ondo and 131 (49.62%) in Ekiti States were recovered from 400 samlpes analyzed. In all, prevalence of UTIs with positive cultures was 66.0%. Escherichia coli only was 56.5%, mixed-infection (9.5%), non-E. coli infection (12.5%) and no growth (21.5%). Resistance to antibiotics was high with diverse multiple antibiotic resistance patterns. Greater percentage of the screened representative UPEC isolates belonged to phylogenetic group D (65.0%), group A (28.0%), group B1 (6.7%) and none to group B2.Escherichia coli belonging to phylogenetic group D appears to be a predominant uropathogen in this study area. Presence of chuA gene in most of the isolates shows the significance of iron acquisition in the pathogenesis and urovirulence of UPEC.

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Section: Discussionmentioning

confidence: 70%

Phenotypic Identification and Phylogenetic Characterization of Uropathogenic Escherichia coli in Symptomatic Pregnant Women With Urinary Tract Infections in South-Western Nigeria

Abiodun¹,

Olufunke²,

Dunah³

et al. 2014

IJB

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“…In addition, yersiniabactin is disproportionately associated with antibiotic-resistant strains, including Ͼ90% of strains of the E. coli sequence type 131 (ST131), an alarming pandemic multidrug-resistant (MDR) clonal group (48)(49)(50)(51), and Ͼ60% of respiratory carbapenemase-producing K. pneumoniae strains, compared to 10% of susceptible K. pneumoniae strains (41). Novel antimicrobial agents or vaccines that target yersiniabactin iron transport or other pathogen-associated nutrient acquisition systems may provide an effective strategy to combat the rising surge of antibiotic-resistant common infections.…”

Section: Figmentioning

confidence: 99%

Blocking Yersiniabactin Import Attenuates Extraintestinal Pathogenic Escherichia coli in Cystitis and Pyelonephritis and Represents a Novel Target To Prevent Urinary Tract Infection

et al. 2015

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The emergence and spread of extended-spectrum beta-lactamases and carbapenemases among common bacterial pathogens are threatening our ability to treat routine hospital-and community-acquired infections. With the pipeline for new antibiotics virtually empty, there is an urgent need to develop novel therapeutics. Bacteria require iron to establish infection, and specialized pathogen-associated iron acquisition systems like yersiniabactin, common among pathogenic species in the family Enterobacteriaceae, including multidrug-resistant Klebsiella pneumoniae and pathogenic Escherichia coli, represent potentially novel therapeutic targets. Although the yersiniabactin system was recently identified as a vaccine target for uropathogenic E. coli (UPEC)-mediated urinary tract infection (UTI), its contribution to UPEC pathogenesis is unknown. Using an E. coli mutant (strain 536⌬fyuA) unable to acquire yersiniabactin during infection, we established the yersiniabactin receptor as a UPEC virulence factor during cystitis and pyelonephritis, a fitness factor during bacteremia, and a surface-accessible target of the experimental FyuA vaccine. In addition, we determined through transcriptome sequencing (RNA-seq) analyses of RNA from E. coli causing cystitis in women that iron acquisition systems, including the yersiniabactin system, are highly expressed by bacteria during natural uncomplicated UTI. Given that yersiniabactin contributes to the virulence of several pathogenic species in the family Enterobacteriaceae, including UPEC, and is frequently associated with multidrug-resistant strains, it represents a promising novel target to combat antibiotic-resistant infections.W idespread and increasing antibiotic resistance among bacterial pathogens that cause some of our most common health care-associated and community-acquired infections is jeopardizing our ability to prevent and treat routine infectious diseases (1). Two pathogens of particular concern are uropathogenic Escherichia coli (UPEC), which causes the majority (80%) of uncomplicated urinary tract infections (UTI) (2), and Klebsiella pneumoniae, a frequent cause of hospital-acquired pneumonia and UTI (3). Without adequate treatment, both UPEC and K. pneumoniae can breach epithelial and endothelial barriers to gain access to the bloodstream, causing life-threatening bacteremia (4). E. coli rates of resistance to fluoroquinolones and third-generation cephalosporins now exceed 50% in 5 of 6 global regions, and similar resistance rates were reported for K. pneumoniae worldwide (5). Unfortunately, the treatment of severe infections caused by these species must rely on carbapenems, the last resort to treat severe community-and hospital-acquired infections (6). Not only are these antibacterial compounds more expensive and less available in resource-constrained settings, but their extended use contributes to the spread of carbapenem-resistant Enterobacteriaceae (CRE), a serious global public health concern (7).Increasing rates of antimicrobial resistance and limited new therapeut...

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“…Indeed, resistance to fluoroquinolones and ESC due to the production of extended-spectrum ␤-lactamases (ESBL) by E. coli isolates has increased steadily over the last 20 years. There is also evidence to suggest that this increase in resistance is linked to the worldwide spread, since 2008, of a specific clone of E. coli, E. coli sequence type 131 (ST131) (4)(5)(6)(7)(8)(9)(10).…”

mentioning

confidence: 99%

Escherichia coli ST131, an Intriguing Clonal Group

2014

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SUMMARY In 2008, a previously unknown Escherichia coli clonal group, sequence type 131 (ST131), was identified on three continents. Today, ST131 is the predominant E. coli lineage among extraintestinal pathogenic E. coli (ExPEC) isolates worldwide. Retrospective studies have suggested that it may originally have risen to prominence as early as 2003. Unlike other classical group B2 ExPEC isolates, ST131 isolates are commonly reported to produce extended-spectrum β-lactamases, such as CTX-M-15, and almost all are resistant to fluoroquinolones. Moreover, ST131 E. coli isolates are considered to be truly pathogenic, due to the spectrum of infections they cause in both community and hospital settings and the large number of virulence-associated genes they contain. ST131 isolates therefore seem to contradict the widely held view that high levels of antimicrobial resistance are necessarily associated with a fitness cost leading to a decrease in pathogenesis. Six years after the first description of E. coli ST131, this review outlines the principal traits of ST131 clonal group isolates, based on the growing body of published data, and highlights what is currently known and what we need to find out to provide public health authorities with better information to help combat ST131.

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Escherichia coliSequence Type ST131 as the Major Cause of Serious Multidrug‐ResistantE. coliInfections in the United States

Cited by 448 publications

References 29 publications

Phenotypic Identification and Phylogenetic Characterization of Uropathogenic Escherichia coli in Symptomatic Pregnant Women With Urinary Tract Infections in South-Western Nigeria

Phenotypic Identification and Phylogenetic Characterization of Uropathogenic Escherichia coli in Symptomatic Pregnant Women With Urinary Tract Infections in South-Western Nigeria

Blocking Yersiniabactin Import Attenuates Extraintestinal Pathogenic Escherichia coli in Cystitis and Pyelonephritis and Represents a Novel Target To Prevent Urinary Tract Infection

Escherichia coli ST131, an Intriguing Clonal Group

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