Molecular epidemiology of extraintestinal pathogenic Escherichia coli isolates from a regional cohort of elderly patients highlights the prevalence of ST131 strains with increased antimicrobial resistance in both community and hospital care settings
Molecular epidemiology of extraintestinal pathogenic Escherichia coli isolates from a regional cohort of elderly patients highlights the prevalence of ST131 strains with increased antimicrobial resistance in both community and hospital care settings
复制标题
DOI：
10.1093/jac/dkr349
复制
发表时间：
2011-11-01
影响因子：
5.2
通讯作者：
McNally, Alan
中科院分区：
文献类型：
--
作者：
Croxall, Gemma;Hale, James;McNally, Alan
目的：了解社区和医院老年尿路感染患者大肠埃希菌的分子流行病学及耐药情况。方法：从诺丁汉地区老年患者尿液中分离到大肠埃希菌，进行药敏试验、聚合酶链式反应检测毒力基因和多位点基因分型。结果：社区和医院来源的菌株之间未发现耐药性水平或毒力基因图谱的相关性。ST131(其中ST代表序列类型)是在医院和社区样本中发现的主要ST，对测试小组显示出高水平的抗生素耐药性，但与其他ST相比，并不具有明显更多的毒力基因阵列或特定的基因图谱。结论：致尿系大肠杆菌的耐药性水平或毒力基因拥有与患者的医疗保健环境没有直接关系，但抗生素耐药性和毒力基因拥有情况随克隆群而异。ST131具有很高的毒力并表现出高水平的抗生素耐药性，但其毒力似乎并不是由于拥有特定的毒力相关基因集或拥有任何毒力相关基因的水平显著高于其他任何ST。
Objectives: To assess the molecular epidemiology and prevalence of antibiotic resistance in Escherichia coli causing urinary tract infections of elderly patients from community and hospital settings. Also, to determine whether the possession of antibiotic resistance and virulence-associated genes can be linked to patient location or the clonal group of the organisms in question.Methods: E. coli were isolated from the urine samples of elderly patients from the Nottingham area, and subjected to antibiotic susceptibility testing, virulence gene detection by PCR and multilocus sequence typing.Results: No correlation was observed between community- or hospital-derived strains with regard to antibiotic resistance levels or virulence gene profiles. E. coli ST131 (where ST stands for sequence type) was the predominant ST found in both hospital and community samples, and demonstrated high levels of antibiotic resistance to the test panel, but did not possess a significantly larger array of virulence genes or a specific gene profile compared with other STs.Conclusions: The level of antibiotic resistance or virulence gene possession in uropathogenic E. coli is not directly associated with the healthcare setting of the patient, but there is a variation in antibiotic resistance and virulence gene possession depending on clonal group. ST131 is highly virulent and demonstrates high levels of antibiotic resistance, but its virulence does not appear to be attributable to the possession of a specific virulence-associated gene set or the possession of any virulence-associated gene in significantly higher levels than in any other ST.