Molecular Epidemiology over an 11-Year Period (2000 to 2010) of Extended-Spectrum β-Lactamase-Producing Escherichia coli Causing Bacteremia in a Centralized Canadian Region
Molecular Epidemiology over an 11-Year Period (2000 to 2010) of Extended-Spectrum β-Lactamase-Producing Escherichia coli Causing Bacteremia in a Centralized Canadian Region
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DOI：
10.1128/jcm.06025-11
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发表时间：
2012-02-01
影响因子：
9.4
通讯作者：
Pitout, Johann D. D.
中科院分区：
文献类型：
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作者：
Peirano, Gisele;van der Bij, Akke K.;Pitout, Johann D. D.
一项研究旨在评估序列类型的重要性，产超广谱β-内酰胺酶（ESBL）的大肠杆菌分离株引起菌血症超过11年的时间（2000年至2010年）在加拿大的一个集中地区。共有197例患者发生感染，其中大多数为社区发病的尿脓毒症，产ESBL大肠埃希菌的患病率显著增加。大肠杆菌在研究的后期。大多数E.大肠杆菌分离株产生CTX-M-15或CTX-M-14。我们在91%的分离株中鉴定了7种不同的主要序列类型（即，ST 10克隆复合物、ST 38、ST 131、ST 315、ST 393、ST 405和ST 648），并提供了对其临床和分子特征的深入了解。ST 38是最敏感的抗菌素序列类型，在2000年至2004年期间占主导地位，但在2008年后消失。ST 131是最耐药的序列型，该序列型的单一脉冲型的流入导致产ESBL的E.自2007年以来，2010年，产ESBL的大肠杆菌中有49/63株（78%）为阳性。大肠杆菌分离株属于ST 131，并且该序列类型已在加拿大阿尔伯塔的卡尔加里确立其自身为主要耐药病原体，在我们区域内构成重要的新的公共卫生威胁。我们迫切需要精心设计的流行病学和分子研究，以了解传播动力学，风险因素和水库为E。coli ST 131。这将提供洞察这种多重耐药序列类型的出现和传播。
A study was designed to assess the importance of sequence types among extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli isolates causing bacteremia over an 11-year period (2000 to 2010) in a centralized Canadian region. A total of 197 patients with incident infections were identified; the majority presented with community-onset urosepsis, with a significant increase in the prevalence of ESBL-producing E. coli during the later part of the study. The majority of E. coli isolates produced either CTX-M-15 or CTX-M-14. We identified 7 different major sequence types among 91% of isolates (i.e., the ST10 clonal complex, ST38, ST131, ST315, ST393, ST405, and ST648) and provided insight into their clinical and molecular characteristics. ST38 was the most antimicrobial-susceptible sequence type and predominated during 2000 to 2004 but disappeared after 2008. ST131 was the most antimicrobial-resistant sequence type, and the influx of a single pulsotype of this sequence type was responsible for the significant increase of ESBL-producing E. coli strains since 2007. During 2010, 49/63 (78%) of the ESBL-producing E. coli isolates belonged to ST131, and this sequence type had established itself as a major drug-resistant pathogen in Calgary, Alberta, Canada, posing an important new public health threat within our region. We urgently need well-designed epidemiological and molecular studies to understand the dynamics of transmission, risk factors, and reservoirs for E. coli ST131. This will provide insight into the emergence and spread of this multiresistant sequence type.