Population dynamics of an Escherichia coli ST131 lineage during recurrent urinary tract infection
Population dynamics of an Escherichia coli ST131 lineage during recurrent urinary tract infection
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DOI：
10.1038/s41467-019-11571-5
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发表时间：
2019-08-13
影响因子：
16.6
通讯作者：
Beatson, Scott A.
中科院分区：
文献类型：
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作者：
Forde, Brian M.;Roberts, Leah W.;Beatson, Scott A.
复发性尿路感染(RUTIs)非常常见，大约25%的女性在初次感染后一年内复发。大肠埃希菌ST131是一种全球占主导地位的多药耐药克隆，与高RuTI率相关。在这里，我们展示了自20世纪70年代以来一名患有Ruti的老年妇女在5年内ST131人口的动态。利用全基因组测序，我们确定了一个与Ruti相关的本土克隆谱系(P1a)，并在粪便菌群中持续存在，为Ruti的肠道储存库提供了令人信服的证据。我们还表明，P1a谱系具有大量的质粒多样性，导致耐药和敏感的肠道分离株共存，尽管经常接受治疗。我们的纵向研究对单个个体内的克隆谱系进行了独特的全面的基因组分析，并提出了一种群体范围的耐药机制，使其能够快速适应波动的抗生素暴露。
Recurrent urinary tract infections (rUTIs) are extremely common, with similar to 25% of all women experiencing a recurrence within 1 year of their original infection. Escherichia coli ST131 is a globally dominant multidrug resistant clone associated with high rates of rUTI. Here, we show the dynamics of an ST131 population over a 5-year period from one elderly woman with rUTI since the 1970s. Using whole genome sequencing, we identify an indigenous clonal lineage (P1A) linked to rUTI and persistence in the fecal flora, providing compelling evidence of an intestinal reservoir of rUTI. We also show that the P1A lineage possesses substantial plasmid diversity, resulting in the coexistence of antibiotic resistant and sensitive intestinal isolates despite frequent treatment. Our longitudinal study provides a unique comprehensive genomic analysis of a clonal lineage within a single individual and suggests a population-wide resistance mechanism enabling rapid adaptation to fluctuating antibiotic exposure.