Global Spread of Mobile Antimicrobial Drug Resistance Determinants in Human and Animal<i>Escherichia coli</i>and<i>Salmonella</i>Strains Causing Community‐Acquired Infections

Ajiboye, Remi M.; Solberg, Owen D.; Lee, Bryan M; Raphael, Eva; DebRoy, Chitrita; Riley, Lee W.

doi:10.1086/600301

Cited by 78 publications

(54 citation statements)

References 24 publications

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“…Antibiotics are used on a large scale in other ecological niches, for instance in animals for food production. In this context, these antibiotics may also contribute as sources or reservoirs of integrons carrying resistance genes [29].…”

Section: Resultsmentioning

confidence: 99%

Class 1 integrons in environmental and clinical isolates of Pseudomonas aeruginosa

Ruiz-Martínez

López-Jiménez

Fusté

et al. 2011

International Journal of Antimicrobial Agents

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The aims of this study were to ascertain the presence and spread of class 1 integrons among environmental and clinical isolates of Pseudomonas aeruginosa and to characterise their variable regions. A total of 76 isolates (56 clinical and 20 environmental) were studied. The presence of plasmids was explored, and polymerase chain reaction (PCR) was used for integron detection. All amplicons were sequenced. PCR detected class 1 integrons in 26 of the 56 clinical isolates; environmental isolates were integron-free. No plasmids were found, thus all the integrons found are possibly on the chromosome. Most isolates presented one amplicon, except PA110514 and PA116136, which showed two PCR products each.Variable regions revealed that 18 strains carried only one gene involved in aminoglycoside resistance, whereas in 3 strains gene cassettes were not found. The most prevalent cassettes among isolates were those encoding aminoglycoside adenyltransferase B (aadB). Several of the strains had acquired the same or a highly similar cassette array as those detected in geographically distant P. aeruginosa. This finding suggests that contact with bacterial reservoirs contributes to the evolution of this pathogen towards multiresistance. Empty structures found may represent a reservoir increasing the capacity to adapt to the environment. However, these integrons are not retained when the selective pressure disappears. It is hypothesised that integrons containing gene cassettes are crucial vehicles for the rapid horizontal transfer of resistance. If this is so, reduced use of antibiotics may lead to a significant decrease in the carriage of integrons among P. aeruginosa strains.

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Section: Resultsmentioning

confidence: 99%

Class 1 integrons in environmental and clinical isolates of Pseudomonas aeruginosa

Ruiz-Martínez

López-Jiménez

Fusté

et al. 2011

International Journal of Antimicrobial Agents

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“…Since the clinical use of SXT is limited in Japan, the possibility of resistance resulting from selection pressure of high clinical usage of this drug is unlikely. It is possible that SXT use in agriculture and animal husbandry may not only be maintaining the pool of drug-resistant strains but also the mobile genetic elements harboring drug-resistant genes that are introduced into the human population (20,21). This study demonstrates that even in a relatively remote community in Japan, UPECs, whether resistant or not, exhibit a clonal distribution.…”

mentioning

confidence: 82%

Molecular Epidemiological Characterization of Uropathogenic Escherichia coli from an Outpatient Urology Clinic in Rural Japan

Umene¹,

Wong²,

Satoh³

et al. 2015

J Clin Microbiol

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gIn the remote Japanese community of Saku, a rural town in the Nagano Prefecture, a large proportion of outpatient urinary tract infections was caused by well-recognized globally dispersed clonal lineages of uropathogenic Escherichia coli (UPEC). However, most of these strains were drug susceptible, suggesting that factors other than selection pressure account for the clonal spread of drug-susceptible UPEC. In Japan, most characterizations of uropathogenic Escherichia coli (UPEC) strains have been limited to hospital settings where the proportion of drug-resistant strains may be higher than that in community-associated UPEC strains (1-4). Therefore, to assess the prevalence of antimicrobial resistance and the clonal composition of UPEC in a community setting, we studied patients at an outpatient clinic in Saku, a remote rural town in the Nagano Prefecture of Japan.Patients presenting to the clinic between October 2008 and September 2009 with clinically suspected urinary tract infection (UTI) and the presence of pyuria were recruited into the study. All men and women reporting any urinary tract abnormality, history of urinary catheter use, cancer, diabetes, or other medical condition requiring hospitalization were classified as having a complicated UTI. Women without these features were classified as having an uncomplicated UTI. Patients also completed a questionnaire which included various medical, exposure, and demographic questions. Each patient provided written informed consent to participate. Approval was obtained from the institutional review board of the National Institute of Infectious Diseases, Japan. Antimicrobial susceptibility testing was performed for all E. coli isolates with the Vitek 2 compact system (bioMérieux, Marcy l'Etoile, France) according to the manufacturer's instructions. The antimicrobial agents tested were cefazolin, cefotiam, ceftriaxone, piperacillin-tazobactam, levofloxacin, and trimethoprimsulfamethoxazole (SXT). An isolate was considered to be multidrug resistant if it exhibited nonsusceptibility to at least one agent in three or more antimicrobial categories (5). Each E. coli isolate was typed by multilocus sequence typing (MLST). MLST was performed according to the protocol described on the University of Warwick MLST database website (http://mlst.warwick.ac.uk /mlst/). Allelic profiles and sequence types (ST) were assigned according to the aforementioned website's scheme. Clonal complexes (CCs) were defined as groups of isolates with an identical ST or one or two allele differences from another ST within the CC. The risk factors were compared by assessing odds ratios (OR) with 95% Cornfield approximation confidence intervals (CI). Statistical significance was defined as a P value of Ͻ0.05.Among 199 participants, 129 completed the questionnaire. Of these, 114 (88%) were women and 15 (12%) were men; 99 (77%) had an uncomplicated UTI, whereas 30 (23%) had a complicated UTI. Patients who had diarrhea during the 6-month period prior to the current UTI and patients who lived in a hous...

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“…The bacterial DNA was extracted by a freeze-boil method, and PCR amplification was carried out as previously described (15). Primer sequences for PCR analysis of fimH genotyping, ␤-lactamase genes, class 1 integron, and associated gene cassettes were used as previously described (Table 1).…”

Section: Strain Collection the Clinical Microbiology Laboratory Of Smentioning

confidence: 99%

Clonal Composition and Community Clustering of Drug-Susceptible and -Resistant Escherichia coli Isolates from Bloodstream Infections

Adams‐Sapper

Diep

Perdreau-Remington

et al. 2013

Antimicrob Agents Chemother

107

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b Multidrug-resistant Escherichia coli strains belonging to a single lineage frequently account for a large proportion of extraintestinal E. coli infections in many parts of the world. However, limited information exists on the community prevalence and clonal composition of drug-susceptible E. coli strains. Between July 2007 and September 2010, we analyzed all consecutively collected Gram-negative bacterial isolates from patients with bloodstream infection (BSI) admitted to a public hospital in San Francisco for drug susceptibility and associated drug resistance genes. The E. coli isolates were genotyped for fimH single nucleotide polymorphisms (SNPs) and multilocus sequence types (MLSTs). Among 539 isolates, E. coli accounted for 249 (46%); 74 (30%) of them were susceptible to all tested drugs, and 129 (52%) were multidrug resistant (MDR). Only five MLST genotypes accounted for two-thirds of the E. coli isolates; the most common were ST131 (23%) and ST95 (18%). Forty-seven (92%) of 51 ST131 isolates, as opposed to only 8 (20%) of 40 ST95 isolates, were MDR (P < 0.0001). The Simpson's diversity index for drug-susceptible ST genotypes was 87%, while the index for MDR ST genotypes was 81%. ST95 strains were comprised of four fimH types, and one of these (f-6) accounted for 67% of the 21 susceptible isolates (P < 0.003). A large proportion (>70%) of both MDR and susceptible E. coli BSI isolates represented community-onset infections. These observations show that factors other than the selective pressures of antimicrobial agents used in hospitals contribute to community-onset extraintestinal infections caused by clonal groups of E. coli regardless of their drug resistance.

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Global Spread of Mobile Antimicrobial Drug Resistance Determinants in Human and AnimalEscherichia coliandSalmonellaStrains Causing Community‐Acquired Infections

Abstract: Common community-acquired human drug-resistant infections are caused by bacterial strains that harbor mobile drug resistance determinants of identical sequences that are found in diverse bacterial species from varied animal sources worldwide.

Cited by 78 publications

References 24 publications

Class 1 integrons in environmental and clinical isolates of Pseudomonas aeruginosa

Class 1 integrons in environmental and clinical isolates of Pseudomonas aeruginosa

Molecular Epidemiological Characterization of Uropathogenic Escherichia coli from an Outpatient Urology Clinic in Rural Japan

Clonal Composition and Community Clustering of Drug-Susceptible and -Resistant Escherichia coli Isolates from Bloodstream Infections

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