Epidemic Clonal Groups of Escherichia coli as a Cause of Antimicrobial-Resistant Urinary Tract Infections in Canada, 2002 to 2004
Epidemic Clonal Groups of Escherichia coli as a Cause of Antimicrobial-Resistant Urinary Tract Infections in Canada, 2002 to 2004
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DOI：
10.1128/aac.00297-09
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发表时间：
2009-07-01
影响因子：
4.9
通讯作者：
Zhanel, George G.
中科院分区：
文献类型：
--
作者：
Johnson, James R.;Menard, Megan;Zhanel, George G.
克隆传播在多大程度上促成了大肠杆菌出现的抗菌素耐药性尚不完全确定。为了在最近的全国代表性菌株收集中解决这个问题，在2002年至2004年从加拿大各地回收的199株大肠杆菌尿液分离株中寻找了三个已建立的耐药大肠杆菌克隆群（即克隆群a，大肠杆菌O15:K52:H1和序列型131 [ST131]），并根据对甲氧嘧啶-磺胺甲恶唑（TS）和氟喹诺酮类药物（FQs）的耐药性进行分层。对分离株的克隆背景、毒力基因型和宏观酶切谱进行了评估。3个克隆类群占总分离株的37.2%，但占ts敏感（TS-S）和fq敏感（FQ-S）分离株的0%，占ts耐药（TS-R）和FQ-S分离株的20%，占TS-S和FQ-R分离株的60%，占TS-R和FQ-R分离株的68% （P < 0.001）。大肠杆菌ST131是最常见的克隆群，占总分离株的23.1%，占FQ-R分离株的44%。几乎所有ST131分离株均为FQ-R(96%)，但值得注意的是，对头孢菌素敏感（98%）。虽然FQ-R克隆群分离株的独特毒力分布不如敏感株广泛，但明显比其他FQ-R分离株广泛。这些结果表明，在所研究的大肠杆菌尿液分离株中，对TS和FQs的耐药性具有突出的克隆成分，其中O15:K52:H1克隆群，特别是大肠杆菌ST131是主要贡献者。这些克隆群似乎比具有相当耐药性的分离株更具毒性，可能有助于它们成功地成为新兴的多重耐药病原体。
The extent to which clonal spread contributes to emerging antimicrobial resistance in Escherichia coli is incompletely defined. To address this question within a recent, nationally representative strain collection, three established drug-resistant E. coli clonal groups (i.e., clonal group A, E. coli O15:K52:H1, and sequence type 131 [ST131]) were sought among 199 E. coli urine isolates recovered from across Canada from 2002 to 2004, with stratification by resistance to trimethoprim-sulfamethoxazole (TS) and fluoro-quinolones (FQs). The isolates' clonal backgrounds, virulence genotypes, and macrorestriction profiles were assessed. The three clonal groups were found to account for 37.2% of isolates overall, but accounted for 0% of TS-susceptible (TS-S) and FQ-susceptible (FQ-S) isolates, 20% of TS-resistant (TS-R) and FQ-S isolates, 60% of TS-S and FQ-R isolates, and 68% of TS-R and FQ-R isolates (P < 0.001). E. coli ST131, the most prevalent clonal group, accounted for 23.1% of isolates overall and for 44% of the FQ-R isolates. Nearly all ST131 isolates were FQ-R (96%) but, notably, cephalosporin susceptible (98%). Although the distinctive virulence profiles of the FQ-R clonal group isolates were less extensive than those of the susceptible isolates, they were significantly more extensive than those of the other FQ-R isolates. These findings indicate that among the E. coli urine isolates studied, resistance to TS and FQs has a prominent clonal component, with the O15:K52:H1 clonal group and especially E. coli ST131 being the major contributors. These clonal groups appear to be more virulent than comparably resistant isolates, possibly contributing to their success as emerging multi-drug-resistant pathogens.