Epidemiology and Antimicrobial Resistance Characteristics of the Sequence Type 131-H30 Subclone Among Extraintestinal Escherichia coli Collected From US Children

Miles-Jay, Arianna; Weissman, Scott J.; Adler, Amanda; Tchesnokova, Veronika; Sokurenko, Evgeni V.; Baseman, Janet; Zerr, Danielle M.

doi:10.1093/cid/cix805

Cited by 9 publications

(4 citation statements)

References 36 publications

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“…Unlike intestinal pathogenic E. coli, which is commonly associated with outbreaks, ExPEC infections are historically considered sporadic, and tracking ExPEC transmission has not been a clinical or public health priority. However, the widespread dissemination of antimicrobialresistant lineages such as sequence type (ST) 131-H30 (also known as ST131 Clade C), a dominant multidrug-resistant (MDR) ExPEC lineage in both adults and children, has brought new interest to understanding the transmission dynamics of these common pathogens [2,3]. In particular, the relative importance of healthcare vs. community transmission to the propagation of MDR ExPEC lineages remains poorly defined, though recent work indicates community exposures may be more important in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Whole Genome Sequencing Detects Minimal Clustering Among Escherichia coli Sequence Type 131-H30 Isolates Collected From United States Children’s Hospitals

Miles-Jay

Weissman

Adler³

et al. 2020

Journal of the Pediatric Infectious Diseases Society

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We applied whole genome sequencing to identify putative transmission clusters among clinical multidrug-resistant Escherichia coli sequence type 131-H30 isolates from 4 United States children’s hospitals. Of 126 isolates, 17 were involved in 8 putative transmission clusters; 4 clusters showed evidence of healthcare-associated epidemiologic linkages. Geographic clustering analyses showed weak geographic clustering.

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Section: Introductionmentioning

confidence: 99%

Whole Genome Sequencing Detects Minimal Clustering Among Escherichia coli Sequence Type 131-H30 Isolates Collected From United States Children’s Hospitals

Miles-Jay

Weissman

Adler³

et al. 2020

Journal of the Pediatric Infectious Diseases Society

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“…In the US and worldwide, the CTX-M-type ESBL-producing Enterobacteriaceae (CTX-M Ent) are the predominant ESBL-producing strains, with the clonal multi-locus sequence type (ST) 131 E. coli harboring CTX-M-15 (CTX-M-1 group) being the most commonly reported in both adult and pediatric studies [ 7 , 8 ]. However, several other CTX-M types continue to circulate in Ent and are equally concerning, highly resistant pathogens that can be acquired in the community [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

The Clinical and Molecular Epidemiology of CTX-M-9 Group Producing Enterobacteriaceae Infections in Children

et al. 2019

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Introduction The pandemic of extended-spectrum beta-lactamase-(ESBL)-producing Enterobacteriaceae (Ent) is strongly linked to the dissemination of CTX-M-type-ESBL-Ent. We sought to define the epidemiology of infections in children due to an emerging resistance type, CTX-M-9-group-producing-Ent (CTX-M-9-grp-Ent). Methods A retrospective matched case-control analysis of children with CTX-M-9-grp-Ent infections who received medical care at three Chicago area hospitals was performed. Cases were defined as children possessing extended-spectrum cephalosporin-resistant (ESC-R) infections due to bla CTX-M-9 . PCR and DNA analysis assessed beta-lactamase ( bla ) genes, multi-locus sequence types (MLST) and phylogenetic grouping of E. coli . Controls were children with ESC-susceptible (ESC-S)-Ent infections matched one case to three controls by age, source, and hospital. The clinical-epidemiologic predictors of CTX-M-9-grp-Ent infection were assessed. Results Of 356 ESC-R-Ent isolates from children (median age 4.1 years), the CTX-M-9-group was the solely detected bla gene in 44 (12.4%). The predominant species was E. coli (91%) of virulent phylogroups D (60%) and B2 (40%). MLST revealed multiple strain types. On multivariable analysis, CTX-M-9-grp-Ent occurred more often in E. coli than other Ent genera (OR 7.4, 95% CI 2.4, 27.2), children of non-Black-White-Hispanic race (OR 7.4, 95% CI 2.4, 28.2), and outpatients (OR 4.5, 95% CI 1.7, 12.3), which was a very unexpected finding for infections due to antibiotic-resistant bacteria. Residents of South Chicago had a 6.7 times higher odds of having CTX-M-9-grp-Ent infections than those in the reference region (West), while residence in Northwestern Chicago was associated with an 81% decreased odds of infection. Other demographic, comorbidity, invasive-device, and antibiotic use differences were not found. Conclusion CTX-M-9-grp-Ent infection may be associated with patient residence and is occurring in children without traditional in-patient exposure risk factors. This suggests that among children, the community environment may be a key contributor in the spread of these resistant pathogens.

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“…Unlike intestinal pathogenic E. coli , which is commonly associated with outbreaks, ExPEC infections are historically considered sporadic, and tracking ExPEC transmission has not been a clinical or public health priority. However, the widespread dissemination of antimicrobial-resistant lineages such as sequence type (ST) 131- H30 (also known as ST131 Clade C), a dominant multidrug-resistant (MDR) ExPEC lineage in both adults and children, has brought new interest to understanding the transmission dynamics of these common pathogens [2,3]. In particular, the relative importance of healthcare vs. community transmission to the propagation of MDR ExPEC lineages remains poorly defined, though recent work indicates community exposures may be more important in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Whole genome sequencing detects minimal clustering amongEscherichia coliSequence Type 131H30isolates collected from U.S. children’s hospitals

Miles-Jay

Weissmann

Adler³

et al. 2019

Preprint

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Escherichia coli sequence type 131 H30 has garnered global attention as a dominant antimicrobial-resistant lineage of extraintestinal pathogenic E. coli, but its transmission dynamics remain undefined. We applied whole genome sequencing to identify putative transmission clusters among clinical isolates of H30 from children across the U.S. Of 126 isolates, 17 were involved in 8 putative transmission clusters; 4 clusters involved isolates with some evidence of healthcare-associated epidemiologic linkages. Geographic clustering analyses showed weak geographic clustering. These findings are consistent with a framework where within-hospital transmission is not a main contributor to the propagation of H30 in a pediatric setting.

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Epidemiology and Antimicrobial Resistance Characteristics of the Sequence Type 131-H30 Subclone Among Extraintestinal Escherichia coli Collected From US Children

Cited by 9 publications

References 36 publications

Whole Genome Sequencing Detects Minimal Clustering Among Escherichia coli Sequence Type 131-H30 Isolates Collected From United States Children’s Hospitals

Whole Genome Sequencing Detects Minimal Clustering Among Escherichia coli Sequence Type 131-H30 Isolates Collected From United States Children’s Hospitals

The Clinical and Molecular Epidemiology of CTX-M-9 Group Producing Enterobacteriaceae Infections in Children

Whole genome sequencing detects minimal clustering amongEscherichia coliSequence Type 131H30isolates collected from U.S. children’s hospitals

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