CTX-M-27-and CTX-M-14-producing, ciprofloxacin-resistant Escherichia coli of the H30 subclonal group within ST131 drive a Japanese regional ESBL epidemic
CTX-M-27-and CTX-M-14-producing, ciprofloxacin-resistant Escherichia coli of the H30 subclonal group within ST131 drive a Japanese regional ESBL epidemic
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DOI：
10.1093/jac/dkv017
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发表时间：
2015-06-01
影响因子：
5.2
通讯作者：
Ichiyama, Satoshi
中科院分区：
文献类型：
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作者：
Matsumura, Yasufumi;Johnson, James R.;Ichiyama, Satoshi
目的：产ESBL大肠埃希菌的全球增加与ST 131克隆群相关，尤其是其产CTX-M-15的H30 Rx亚群。目的了解产ESBL大肠埃希菌的快速传播。方法：对2001 - 2012年日本分离的1079株产ESBL大肠埃希菌进行分子流行病学调查和ESBL相关遗传环境分析。大肠杆菌分离株收集在10个日本急性护理医院。通过PCR和测序确定ESBL类型、ST 131状态、fimH等位基因、H30 Rx定义序列和ESBL相关遗传环境。根据fimH等位基因和H30 Rx状态定义亚克隆组。结果：总体而言，1079株产ESBL大肠杆菌中有461株（43%）。大肠杆菌菌株代表ST 131。根据fimH亚克隆分型，ST 131菌株包括398株fimH等位基因30（H30）型菌株，49株H41型菌株，10株H22型菌株和4株其他fimH型菌株。398株H30分离株包括396株环丙沙星耐药H30 R分离株，其中64株（16%）代表H30 Rx亚群。在2001年至2007年期间，产生CTX-M-14的H30 R亚群占主导地位，占ST 131分离株的46%，而很少检测到产生CTX-M-27的H30 R和产生CTX-M-15的H30 Rx亚群。相比之下，从2008年起，后两个亚群上升为主导，分别占ST 131分离株的45%和24%，而（以前占主导地位的）CTX-M-14-生产H30 R亚群仅占15%。新出现的CTX-M-27-H30 R亚群常具有IS 26-Delta ISEcp 1-bla（CTX-M-27）-Delta IS 903 D-IS 26-like结构，而较老的CTX-M-14-H30 R亚群常具有ISEcp 1-bla（CTX-M-14）-IS 903 D-like结构。大肠杆菌流行与新鉴定的产生CTX-M-27和CTX-M-14的ST 131 H30 R亚克隆群以及移动的元件IS 26、ISEcp 1和IS 903 D密切相关。
Objectives: The global increase in ESBL-producing Escherichia coli is associated with the ST131 clonal group, especially its CTX-M-15-producing H30Rx subset. To understand the rapid spread of ESBL-producing E. coli in Japan, we investigated the molecular epidemiology and ESBL-associated genetic environments of Japanese ST131 isolates.Methods: Between 2001 and 2012, 1079 ESBL-producing E. coli isolates were collected at 10 Japanese acute-care hospitals. ESBL types, ST131 status, fimH allele, H30Rx-defining sequences and ESBL-associated genetic environments were defined using PCR and sequencing. Subclonal groups were defined based on fimH allele and H30Rx status.Results: Overall, 461 (43%) of the 1079 ESBL-producing E. coli isolates represented ST131. According to fimH-based subclonal typing, the ST131 isolates included 398 fimH allele 30 (H30) isolates, 49 H41 isolates, 10 H22 isolates and 4 other fimH-type isolates. The 398 H30 isolates included 396 ciprofloxacin-resistant H30R isolates, of which 64 (16%) represented the H30Rx subset. Between 2001 and 2007, the CTX-M-14-producing H30R subgroup predominated, accounting for 46% of ST131 isolates, whereas the CTX-M-27-producing H30R and CTX-M-15-producing H30Rx subgroups were rarely detected. In contrast, from 2008 onward the latter two subgroups rose to dominance, accounting for 45% and 24% of ST131 isolates, respectively, versus only 15% for the (formerly dominant) CTX-M-14-producing H30R subgroup. The emergent CTX-M-27-H30R subgroup frequently had an IS26-Delta ISEcp1-bla(CTX-M-27)-Delta IS903D-IS26-like structure, whereas the older CTX-M-14-H30R subgroup frequently had an ISEcp1-bla(CTX-M-14)-IS903D-like structure.Conclusions: This Japanese regional ESBL-producing E. coli epidemic is closely associated with newly identified CTX-M-27- and CTX-M-14-producing ST131 H30R subclonal groups and with mobile elements IS26, ISEcp1 and IS903D.