Genetic analysis of invasive Escherichia coli in Scotland reveals determinants of healthcare-associated versus community-acquired infections.
Genetic analysis of invasive Escherichia coli in Scotland reveals determinants of healthcare-associated versus community-acquired infections.
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DOI：
10.1099/mgen.0.000190
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发表时间：
2018-06
影响因子：
3.9
通讯作者：
Evans TJ
中科院分区：
文献类型：
--
作者：
Goswami C;Fox S;Holden M;Connor M;Leanord A;Evans TJ
由大肠杆菌引起的菌血症是一个日益严重的问题，死亡率很高。影响这些感染的获得性和结局的因素尚不清楚。在这里，我们将2013-2015年在英国苏格兰收集的162株细菌性分离株的全基因组测序的详细遗传数据与临床数据联系起来，以描绘影响医院或社区获取的细菌和宿主因素、结果和抗生素耐药性。我们在这些分离株中发现了四种主要的序列类型：ST131、ST69、ST73和ST95。近50 %的菌血症菌株起源于尿路。ST69在遗传上与其他STS不同，附属基因的共享显著减少，并且与不同的质粒群有明显的差异。毒力基因分布广泛，且在优势菌株间分布不一。ST131与医院感染显著相关，ST69与社区感染显著相关。然而，ST与预后没有关联，尽管与社区相关感染(CAI)患者相比，HAI患者的即时死亡率更高。全基因组关联研究显示，与抗生素持久性有关的基因与HAI显著相关，并与CAI的VI型分泌系统的编码元件显著相关。抗生素耐药性是常见的，存在相关的耐药性基因网络和表型抗生素耐药性。这项研究揭示了大肠杆菌的基因型与其引起菌血症的能力之间的复杂相互作用，以及影响医院或社区感染的一些决定因素。在一定程度上，这些因素是由抗生素的使用所决定的，但菌株特有的因素也很重要。
Bacteraemia caused by Escherichia coli is a growing problem with a significant mortality. The factors that influence the acquisition and outcome of these infections are not clear. Here, we have linked detailed genetic data from the whole-genome sequencing of 162 bacteraemic isolates collected in Scotland, UK, in 2013–2015, with clinical data in order to delineate bacterial and host factors that influence the acquisition in hospital or the community, outcome and antibiotic resistance. We identified four major sequence types (STs) in these isolates: ST131, ST69, ST73 and ST95. Nearly 50 % of the bacteraemic isolates had a urinary origin. ST69 was genetically distinct from the other STs, with significantly less sharing of accessory genes and with a distinct plasmid population. Virulence genes were widespread and diversely distributed between the dominant STs. ST131 was significantly associated with hospital-associated infections (HAIs), and ST69 with those from the community. However, there was no association of ST with outcome, although patients with HAI had a higher immediate mortality compared to those with community-associated infections (CAIs). Genome-wide association studies revealed genes involved in antibiotic persistence as significantly associated with HAIs and those encoding elements of a type VI secretion system with CAIs. Antibiotic resistance was common, and there were networks of correlated resistance genes and phenotypic antibiotic resistance. This study has revealed the complex interactions between the genotype of E. coli and its ability to cause bacteraemia, and some of the determinants influencing hospital or community acquisition. In part, these are shaped by antibiotic usage, but strain-specific factors are also important.
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影响因子：
3.6
作者：
Andersen, C;Rak, B;Benz, R
通讯作者：
Benz, R
影响因子：
5.2
作者：
Gibreel, Tarek M.;Dodgson, Andrew R.;Upton, Mathew
通讯作者：
Upton, Mathew
影响因子：
3.6
作者：
Christensen-Dalsgaard M;Jørgensen MG;Gerdes K
通讯作者：
Gerdes K
David Gene功能分类工具：一种以生物模块为中心的新型算法，可在功能上分析大基因列表。
影响因子：
12.3
作者：
Huang, Da Wei;Sherman, Brad T;Tan, Qina;Collins, Jack R;Alvord, W Gregory;Roayaei, Jean;Stephens, Robert;Baseler, Michael W;Lane, H Clifford;Lempicki, Richard A
通讯作者：
Lempicki, Richard A
影响因子：
4.2
作者：
Dautin N
通讯作者：
Dautin N