Genomic Analysis of Multidrug-Resistant Escherichia coli from North Carolina Community Hospitals: Ongoing Circulation of CTX-M-Producing ST131- H 30Rx and ST131- H 30R1 Strains.

Autor:	Kanamori H; Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA kanamori@med.tohoku.ac.jp.; Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina, USA., Parobek CM; Curriculum in Genetics and Molecular Biology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA., Juliano JJ; Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA., Johnson JR; Division of Infectious Diseases, University of Minnesota, Minneapolis, Minnesota, USA.; Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA., Johnston BD; Division of Infectious Diseases, University of Minnesota, Minneapolis, Minnesota, USA.; Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA., Johnson TJ; Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, Minnesota, USA., Weber DJ; Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.; Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina, USA., Rutala WA; Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.; Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina, USA., Anderson DJ; Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA.; Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA.
Jazyk:	angličtina
Zdroj:	Antimicrobial agents and chemotherapy [Antimicrob Agents Chemother] 2017 Jul 25; Vol. 61 (8). Date of Electronic Publication: 2017 Jul 25 (Print Publication: 2017).
DOI:	10.1128/AAC.00912-17
Abstrakt:	Escherichia coli sequence type 131 (ST131) predominates globally among multidrug-resistant (MDR) E. coli strains. We used whole-genome sequencing (WGS) to investigate 63 MDR E. coli isolates from 7 North Carolina community hospitals (2010 to 2015). Of these, 39 (62%) represented ST131, including 37 (95%) from the ST131- H 30R subclone: 10 (27%) from its H 30R1 subset and 27 (69%) from its H 30Rx subset. ST131 core genomes differed by a median of 15 (range, 0 to 490) single-nucleotide variants (SNVs) overall versus only 7 within H 30R1 (range, 3 to 12 SNVs) and 11 within H 30Rx (range, 0 to 21). The four isolates with identical core genomes were all H 30Rx. Epidemiological and clinical characteristics did not vary significantly by strain type, but many patients with MDR E. coli or H 30Rx infection were critically ill and had poor outcomes. H 30Rx isolates characteristically exhibited fluoroquinolone resistance and CTX-M-15 production, had a high prevalence of trimethoprim-sulfamethoxazole resistance (89%), sul1 (89%), and dfrA17 (85%), and were enriched for specific virulence traits, and all qualified as extraintestinal pathogenic E. coli The high overall prevalence of CTX-M-15 appeared to be possibly attributable to its association with the ST131- H 30Rx subclone and IncF[F2:A1:B-] plasmids. Some phylogenetically clustered non-ST131 MDR E. coli isolates also had distinctive serotypes/ fimH types, fluoroquinolone mutations, CTX-M variants, and IncF types. Thus, WGS analysis of our community hospital source MDR E. coli isolates suggested ongoing circulation and differentiation of E. coli ST131 subclones, with clonal segregation of CTX-M variants, other resistance genes, Inc-type plasmids, and virulence genes. (Copyright © 2017 American Society for Microbiology.)
Databáze:	MEDLINE
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