The Niche for Escherichia coli Sequence Type 131 Among Veterans: Urinary Tract Abnormalities and Long-Term Care Facilities

Drekonja, Dimitri; Kuskowski, Michael A.; Anway, Ruth; Johnston, Brian; Johnson, James R.

doi:10.1093/ofid/ofw138

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…In that regard, host age, although greater in association with FQ-R than with FQ-S isolates, did not differ between the two principal FQ-R subsets, ST1193-H64 and ST131-H30R. This conflicts with a recent study involving mainly non-VAMC clinical isolates in which source hosts were significantly younger for ST1193-H64 than for ST131-H30R (8), possibly due to population differences, as MVAMC patients are mainly elderly men with multiple comorbidities (16).…”

Section: Discussioncontrasting

confidence: 65%

Rapid Emergence, Subsidence, and Molecular Detection of Escherichia coli Sequence Type 1193- fimH64 , a New Disseminated Multidrug-Resistant Commensal and Extraintestinal Pathogen

et al. 2019

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Escherichia coli sequence type 1193 (ST1193) is an emerging multidrugresistant pathogen. We performed longitudinal and cross-sectional surveillance for ST1193 among clinical and fecal E. coli isolates from Minneapolis Veterans Affairs Medical Center (VAMC) patients and their household members, other Minnesota centers, and national VAMCs and compared these ST1193 isolates with archival human and canine ST1193 isolates from Australia (2008). We also developed and extensively validated a novel multiplex PCR assay for ST1193 and its characteristic fimH64 (type 1 fimbrial adhesin) allele. We found that ST1193-H64 (where "H64" refers to a phylogenetic subdivision within ST1193 that is characterized by the fimH64 allele), which was uniformly fluoroquinolone resistant, appeared to emerge in the United States in a geographically staggered fashion beginning around 2011. Its prevalence among clinical and fecal E. coli isolates at the Minneapolis VAMC rose rapidly beginning in 2013, peaked in early 2017, and then plateaued or declined. In comparison with other ST14 complex (STc14) isolates, ST1193-H64 isolates were more extensively multidrug resistant, whereas their virulence genotypes were less extensive but included (uniquely) K1 capsule and fimH64. Pulsed-field gel electrophoresis separated ST1193-H64 isolates from other STc14 isolates and showed genetic commonality between archival Australian versus recent U.S. isolates, fecal versus clinical isolates, and human versus canine isolates. Three main ST1193 pulsotypes differed significantly in resistance profiles and capsular types; emergent pulsotype 2123 was associated with trimethoprimsulfamethoxazole resistance and K1 (versus K5) capsule. These findings clarify ST1193-H64's temporal prevalence trends as a fluoroquinolone-resistant pathogen and commensal; document clonal subsets with distinctive geographic, temporal, resistance, and virulence gene associations; and establish a new laboratory tool for rapid and simple detection of ST1193-H64.

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Section: Discussioncontrasting

confidence: 65%

Rapid Emergence, Subsidence, and Molecular Detection of Escherichia coli Sequence Type 1193- fimH64 , a New Disseminated Multidrug-Resistant Commensal and Extraintestinal Pathogen

et al. 2019

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“…In contrast, multivariable analysis identified host factors, including the Pitt bacteremia score and Charlson comorbidity index, as correlates of mortality, which is in keeping with previous studies that found that host factors are more important than bacterial factors in determining the severity of E. coli bacteremia (19). Notably, other recent studies found that ST131-H30 was associated with older patients, compromised hosts, antimicrobial resistance, and clinical/microbiological persistence but not with key adverse outcomes (e.g., recurrence or mortality) (22,33).…”

Section: Discussionsupporting

confidence: 86%

Clinical and Molecular Correlates of Escherichia coli Bloodstream Infection from Two Geographically Diverse Centers in Rochester, Minnesota, and Singapore

Mendis

Vasoo

Johnston

et al. 2018

Antimicrob Agents Chemother

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bacteremia is caused mainly by sequence type complex 131 (STc131) and two clades within its fluoroquinolone-resistance-associated 30 subclone,30R1 and 30Rx. We examined clinical and molecular correlates of bacteremia in two geographically distinct centers. We retrospectively studied 251 unique bloodstream isolates from 246 patients (48 from the Mayo Clinic, Rochester, MN [MN], and 198 from Tan Tock Seng Hospital, Singapore [SG]), from October 2013 through March 2014. Isolates underwent PCR for phylogroup, STc, type, and virulence gene profiles, and medical records were reviewed. Although STc131 accounted for 25 to 27% of all bacteremia isolates at each site, its extended-spectrum-β-lactamase (ESBL)-associated30Rx clade was more prominent in SG than in MN (15% versus 4%; = 0.04). In SG only, patients with STc131 (versus other STc isolates) were more likely to receive inactive initial antibiotics (odds ratio, 2.8; = 0.005); this was true specifically for patients with30Rx (odds ratio, 7.0; = 0.005).30Rx comprised 16% of community-onset bacteremia episodes in SG but none in MN. In SG, virulence scores were higher for 30Rx than for30R1, non-30 STc131, and non-STc131 isolates ( < 0.02 for all comparisons). At neither site did mortality differ by clonal status. The ESBL-associated 30Rx clade was more prevalent and more often of community onset in SG, where it predicted inactive empirical treatment. The clonal distribution varies geographically and has potentially important clinical implications. Rapid susceptibility testing and clonal diagnostics for30/30Rx might facilitate earlier prescribing of active therapy.

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“…aSF isolates were from San Francisco General Hospital (6), MVAST isolates were from Minneapolis (11), USVAST isolates were from other states in the United States (10), and “Blood” and “UPEC” isolates were from Seattle (5). …”

Section: Resultsmentioning

confidence: 99%

“…Isolates MVAST0098 (urine), MVAST0176 (blood), MVAST0234 (urine), and MVAST0326 (urine) were obtained at the Minneapolis Veterans Affairs Hospital in Minneapolis, MN, in 2010 and 2011 (11). Isolates designated “USVAST” were obtained in 2011 in VA hospitals from the following locations as described by Colpan et al (12): USVAST184, Ann Arbor, MI; USVAST245, Seattle, WA; USVAST267, Sacramento, CA; USVAST356, Dallas, TX; and USVAST406, Jackson, MS. All of the USVAST isolates were obtained from urine specimens.…”

Section: Methodsmentioning

confidence: 99%

“…These initial strains encompassed the four major sublineages of ST95, as defined by alleles of the fimH marker. We added more geographic diversity with four ST95 isolates from Minnesota (11) and five from other locations in the United States (12). Finally, we included archived sequences of 33 ST95 isolates from the Seattle area (5) in our analysis.…”

Section: Introductionmentioning

confidence: 99%

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Genomic Analysis of Factors Associated with Low Prevalence of Antibiotic Resistance in Extraintestinal Pathogenic Escherichia coli Sequence Type 95 Strains

Stephens

Adams‐Sapper

Sekhon

et al. 2017

mSphere

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Antibiotic resistance in bacterial pathogens is a major public health concern. This work was motivated by the observation that only a small proportion of ST95 isolates, a major pandemic lineage of extraintestinal pathogenic E. coli, have acquired antibiotic resistance, in contrast to many other pandemic lineages. Understanding bacterial genetic factors that may prevent acquisition of resistance could contribute to the development of new biological, medical, or public health strategies to reduce antibiotic-resistant infections.

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The Niche for Escherichia coli Sequence Type 131 Among Veterans: Urinary Tract Abnormalities and Long-Term Care Facilities

Cited by 9 publications

References 19 publications

Rapid Emergence, Subsidence, and Molecular Detection of Escherichia coli Sequence Type 1193- fimH64 , a New Disseminated Multidrug-Resistant Commensal and Extraintestinal Pathogen

Rapid Emergence, Subsidence, and Molecular Detection of Escherichia coli Sequence Type 1193- fimH64 , a New Disseminated Multidrug-Resistant Commensal and Extraintestinal Pathogen

Clinical and Molecular Correlates of Escherichia coli Bloodstream Infection from Two Geographically Diverse Centers in Rochester, Minnesota, and Singapore

Genomic Analysis of Factors Associated with Low Prevalence of Antibiotic Resistance in Extraintestinal Pathogenic Escherichia coli Sequence Type 95 Strains

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