Spatial distribution of Escherichia coli ST131 C subclades in a centralized Canadian urban region
Spatial distribution of Escherichia coli ST131 C subclades in a centralized Canadian urban region
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DOI：
10.1093/jac/dkab020
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发表时间：
2021-02-06
影响因子：
5.2
通讯作者：
Pitout, Johann D. D.
中科院分区：
文献类型：
--
作者：
Nobrega, Diego;Peirano, Gisele;Pitout, Johann D. D.
简介：大肠杆菌ST131是卡尔加里最常见的多药耐药（MDR）大肠杆菌克隆，引起血液感染（bsi）。本研究描述了卡尔加里引起bsi的ST131亚支C1和C2的患者特征和空间分布。方法：对加拿大卡尔加里（2016）地区685例血液中大肠杆菌（n = 685）进行ST131 PCR筛选，并对阳性的141例进行全基因组测序。使用Fisher’s Exact/t检验分析患者特征，并使用空间分析来识别聚类。结果：总体上，21%的大肠杆菌被鉴定为ST131，其中C支占主导地位。ST131-C2与bla（CTX-M-15）相关，MDR明显高于ST131-C1。卡尔加里的空间分布表明，ST131-C1主要存在于长期护理（LTC）居民中，而ST131-C2集中在特定的东北（NE）卡尔加里地区，包括六个没有LTC中心的社区。这个东北地区有来自印度次大陆的高移民和旅游率。结论：本研究表明，ST131 C亚支在卡尔加里具有不同的地理分布格局。我们认为，最近来自某些抗菌素耐药性高风险地区的旅行和移民是导致ST131-C2 NE卡尔加里聚集模式的原因。
Introduction: Escherichia coli ST131 is the most common multidrug-resistant (MDR) E. coli clone causing bloodstream infections (BSIs) in Calgary. This study describes patient characteristics and spatial distribution of ST131 subclades C1 and C2 causing BSIs in Calgary.Methods: E. coli from blood (n = 685) obtained in Calgary, Canada, (2016) were PCR screened for ST131 and positives (n = 141) underwent whole genome sequencing. Patient characteristics were analysed using Fisher's Exact/t-tests and spatial analysis was used to identify clusters.Results: Overall, 21% of E. coli was identified as ST131 and clade C dominated the population. ST131-C2 was associated with bla(CTX-M-15) and significantly more MDR than ST131-C1. The spatial distribution in Calgary showed that ST131-C1 was mainly present in long-term care (LTC) residents whereas ST131-C2 clustered in a specific North East (NE) Calgary sector comprising of six neighbourhoods without LTC centres. This NE sector has high immigration and travel rates from the Indian subcontinent.Conclusions: This study showed that ST131 C subclades have different geographical distribution patterns in Calgary. We believe that recent travel to and immigration from certain high-risk regions for antimicrobial resistance are responsible for the ST131-C2 NE Calgary clustering pattern.