Variation in resistance traits, phylogenetic backgrounds, and virulence genotypes among Escherichia coli clinical isolates from adjacent hospital campuses serving distinct patient populations.
Variation in resistance traits, phylogenetic backgrounds, and virulence genotypes among Escherichia coli clinical isolates from adjacent hospital campuses serving distinct patient populations.
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来自邻近医院园区为不同患者群体提供服务的大肠杆菌临床分离株的耐药性特征、系统发育背景和毒力基因型的变化。
DOI：
10.1128/aac.00048-15
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发表时间：
2015
影响因子：
4.9
通讯作者：
Johnson,JamesR
中科院分区：
文献类型：
--
作者：
Drawz,SarahM;Porter,Stephen;Kuskowski,MichaelA;Johnston,Brian;Clabots,Connie;Kline,Susan;Ferrieri,Patricia;Johnson,JamesR
大肠杆菌序列13型（ST131）是多药耐药肠外感染的一个新原因，具有重要的系统发育亚群，特别是h30和h30rx亚克隆，具有独特的耐药谱，并可能与临床相关。为了明确这些ST131亚克隆在当地的流行情况及其与抗菌素耐药性、生态来源和毒力性状的关系，我们对明尼苏达州明尼阿波利斯市明尼苏达大学医学中心fairview传染病和诊断实验室连续233株大肠杆菌临床分离株（2013年7月和8月）进行了广泛的特征分析，该实验室服务于三个相邻设施（儿童医院和低、高灵敏度成人设施）。ST131占研究分离株的26%（比任何其他克隆群都多），分布相似，与环丙沙星耐药性和广谱β-内酰胺酶（ESBL）的产生密切相关。h30和h30rx亚克隆占大多数ST131分离株，并且ST131与氟喹诺酮类药物耐药性和ESBL产生相关。与st131本身不同，这些亚克隆在不同医院的分布不同，在高锐成人医院最普遍，在儿童医院不存在。ST131及其亚克隆的毒力基因谱比其他耐氟喹诺酮或产生esbl的分离株具有独特性和广泛性。在ST131中，blactx - m -15局限于h30rx分离株，而其他blactx - m变体则局限于非rxh30分离株。脉冲场凝胶电泳记录了全球分布的脉冲型优势，没有局部爆发模式。这些发现有助于阐明h30和h30rx ST131亚克隆的流行病学、生态学和细菌相关性，通过记录高总体患病率，但显著的设施分离，与氟喹诺酮类药物耐药性和特异性ESBL变异的强烈关联，以及独特的毒力基因关联，可能赋予比其他耐药大肠杆菌更强的适应性优势。
Escherichia coli sequence type 13 (ST131), an emergent cause of multidrug-resistant extraintestinal infections, has important phylogenetic subsets, notably theH30 andH30Rx subclones, with distinctive resistance profiles and, possibly, clinical associations. To clarify the local prevalence of these ST131 subclones and their associations with antimicrobial resistance, ecological source, and virulence traits, we extensively characterized 233 consecutive E. coli clinical isolates (July and August 2013) from the University of Minnesota Medical Center-Fairview Infectious Diseases and Diagnostic Laboratory, Minneapolis, MN, which serves three adjacent facilities (a children's hospital and low- and high-acuity adult facilities). ST131 accounted for 26% of the study isolates (more than any other clonal group), was distributed similarly by facility, and was closely associated with ciprofloxacin resistance and extended-spectrum β-lactamase (ESBL) production. TheH30 andH30Rx subclones accounted for most ST131 isolates and for the association of ST131 with fluoroquinolone resistance and ESBL production. Unlike ST131per se, these subclones were distributed differentially by hospital, being most prevalent at the high-acuity adult facility and were absent from the children's hospital. The virulence gene profiles of ST131 and its subclones were distinctive and more extensive than those of other fluoroquinolone-resistant or ESBL-producing isolates. Within ST131,blaCTX-M-15was confined toH30Rx isolates and otherblaCTX-Mvariants to non-RxH30 isolates. Pulsed-field gel electrophoresis documented a predominance of globally distributed pulsotypes and no local outbreak pattern. These findings help clarify the epidemiology, ecology, and bacterial correlates of theH30 andH30Rx ST131 subclones by documenting a high overall prevalence but significant segregation by facility, strong associations with fluoroquinolone resistance and specific ESBL variants, and distinctive virulence gene associations that may confer fitness advantages over other resistant E. coli.