Emergence and dissemination of antimicrobial resistance in Escherichia coli causing bloodstream infections in Norway in 2002–17: a nationwide, longitudinal, microbial population genomic study

Autor: Rebecca A Gladstone, PhD, Alan McNally, ProfPhD, Anna K Pöntinen, PhD, Gerry Tonkin-Hill, MSc, John A Lees, PhD, Kusti Skytén, MSc, François Cléon, PhD, Martin O K Christensen, MSc, Bjørg C Haldorsen, MSc, Kristina K Bye, BSc, Karianne W Gammelsrud, PhD, Reidar Hjetland, PhD, Angela Kümmel, MD, Hege E Larsen, BSc, Paul Christoffer Lindemann, MD, Iren H Löhr, MD, Åshild Marvik, PhD, Einar Nilsen, MD, Marie T Noer, MSc, Gunnar S Simonsen, ProfPhD, Martin Steinbakk, MD, Ståle Tofteland, PhD, Marit Vattøy, BSc, Stephen D Bentley, ProfPhD, Nicholas J Croucher, PhD, Julian Parkhill, ProfPhD, Pål J Johnsen, ProfPhD, Ørjan Samuelsen, ProfPhD, Jukka Corander, ProfPhD
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: The Lancet Microbe, Vol 2, Iss 7, Pp e331-e341 (2021)
Druh dokumentu: article
ISSN: 2666-5247
DOI: 10.1016/S2666-5247(21)00031-8
Popis: Summary: Background: The clonal diversity underpinning trends in multidrug resistant Escherichia coli causing bloodstream infections remains uncertain. We aimed to determine the contribution of individual clones to resistance over time, using large-scale genomics-based molecular epidemiology. Methods: This was a longitudinal, E coli population, genomic, cohort study that sampled isolates from 22 512 E coli bloodstream infections included in the Norwegian surveillance programme on resistant microbes (NORM) from 2002 to 2017. 15 of 22 laboratories were able to share their isolates, and the first 22·5% of isolates from each year were requested. We used whole genome sequencing to infer the population structure (PopPUNK), and we investigated the clade composition of the dominant multidrug resistant clonal complex (CC)131 using genetic markers previously reported for sequence type (ST)131, effective population size (BEAST), and presence of determinants of antimicrobial resistance (ARIBA, PointFinder, and ResFinder databases) over time. We compared these features between the 2002–10 and 2011–17 time periods. We also compared our results with those of a longitudinal study from the UK done between 2001 and 2011. Findings: Of the 3500 isolates requested from the participating laboratories, 3397 (97·1%) were received, of which 3254 (95·8%) were successfully sequenced and included in the analysis. A significant increase in the number of multidrug resistant CC131 isolates from 71 (5·6%) of 1277 in 2002–10 to 207 (10·5%) of 1977 in 2011–17 (p
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