Epidemiological characterization of a nosocomial outbreak of extended spectrum β‐lactamase Escherichia coli ST‐131 confirms the clinical value of core genome multilocus sequence typing
Epidemiological characterization of a nosocomial outbreak of extended spectrum β‐lactamase Escherichia coli ST‐131 confirms the clinical value of core genome multilocus sequence typing
复制标题
超广谱β-内酰胺酶大肠杆菌 ST-131 的医院暴发流行病学特征证实了核心基因组多位点序列分型的临床价值
作者：
H. Woksepp;A. Ryberg;Linda Berglind;T. Schön;Jan Söderman
在临床疑似医院暴发中，提高流行病学分型的精确度至关重要。我们的目的是研究与早期的分子分型方法相比，全基因组测序（WGS）数据的单核苷酸多态性（SNP）分析和核心基因组（cg）多位点序列分型（MLST）是否能更可靠地识别医院内爆发。ESBL-E医院内暴发的16株菌。大肠杆菌ST-131和三种对照菌株进行WGS。通过SNP分析和cgMLST探索序列。cgMLST在爆发分离株和对照分离株之间明显区分（>1400个差异）。所有临床鉴定的暴发分离株均显示出紧密聚集（≥2个等位基因差异），除了两个分离株（>50个等位基因差异）。这些数据证实了具有>50个不同基因的分离株不属于医院爆发。爆发中的SNP数量≤7，而两个不一致的分离株具有>700个SNP。两种ESBL E.大肠杆菌ST-131分离株不属于临床确定的暴发。我们的研究结果说明了WGS在分辨率方面的能力，这可能会避免高估从流行病学数据和以前采用的分子方法判断属于爆发的患者，具有较低的区分能力。
Enhanced precision of epidemiological typing in clinically suspected nosocomial outbreaks is crucial. Our aim was to investigate whether single nucleotide polymorphism (SNP) analysis and core genome (cg) multilocus sequence typing (MLST) of whole genome sequencing (WGS) data would more reliably identify a nosocomial outbreak, compared to earlier molecular typing methods. Sixteen isolates from a nosocomial outbreak of ESBL E. coli ST‐131 in southeastern Sweden and three control strains were subjected to WGS. Sequences were explored by SNP analysis and cgMLST. cgMLST clearly differentiated between the outbreak isolates and the control isolates (>1400 differences). All clinically identified outbreak isolates showed close clustering (≥2 allele differences), except for two isolates (>50 allele differences). These data confirmed that the isolates with >50 differing genes did not belong to the nosocomial outbreak. The number of SNPs within the outbreak was ≤7, whereas the two discrepant isolates had >700 SNPs. Two of the ESBL E. coli ST‐131 isolates did not belong to the clinically identified outbreak. Our results illustrate the power of WGS in terms of resolution, which may avoid overestimation of patients belonging to outbreaks as judged from epidemiological data and previously employed molecular methods with lower discriminatory ability.
DOI：
10.1056/nejmp1215093
发表时间：
2013-01-24
期刊：
The New England journal of medicine
影响因子：
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作者：
Spellberg B;Bartlett JG;Gilbert DN
通讯作者：
Gilbert DN