National survey of Escherichia coli causing extraintestinal infections reveals the spread of drug-resistant clonal groups O25b:H4-B2-ST131, O15:H1-D-ST393 and CGA-D-ST69 with high virulence gene content in Spain

Blanco, Jorge; Mora, Azucena; Mamani, Rosalía; López, Cecilia; Blanco, Miguel; Dahbi, Ghizlane; Herrera, Alexandra; Blanco, Jesús E.; Alonso, Marı́a Pilar; Garcı́a-Garrote, Fernando; Cháves, Fernando; Orellana, María Ángeles; Martínez-Martínez, Luis; Calvo, Jorge; Prats, Guillem; Larrosa, Nieves; González-López, Juan José; López-Cerero, Lorena; Rodríguez-Baño, Jesús; Pascual, Álvaro

doi:10.1093/jac/dkr235

Cited by 119 publications

(105 citation statements)

References 33 publications

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“…coli O25:H4-ST131 has been described as an important human extraintestinal pathogen responsible for community-and hospital-acquired urinary tract and bloodstream infections [14,15,30,31,32,33]. This strain is found globally and produces extended spectrum β-lactamase.…”

Section: Discussionmentioning

confidence: 99%

UPEC strain characterization isolated from Mexican patients with recurrent urinary infections

Morales-Espinosa

Hernández‐Castro

Delgado

et al. 2016

J Infect Dev Ctries

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Introduction: Any microorganism is capable of causing urinary tract infections (UTI). However, Uropathogenic Escherichia coli (UPEC) is responsible for the majority of UTI. A variety of virulence genes have been identified in UPEC. Diverse epidemiological studies support that specific subsets of genes are characteristic of each E. coli uropathogenic subtype involved in the development of cystitis, pyelonephritis, and urosepsis. Methodology: Twenty-three E. coli strains isolated from women with cystitis, 25 from men with prostatitis were characterized according to serotype, virulence genes, PFGE profile and susceptibility antimicrobials. Results: E. coli O25:H4-ST131 was more frequently isolated from cystitis than prostatitis. The majority of cystitis strains presented almost all the virulence genes, contrary to 60% of prostatitis strains. The strains characterized by serology, PFGE and MLST and virulence profile showed that cystitis strains shared a lineage with their own genomic fingerprint, indicating that these strains derived from a common ancestor. The prostatitis strains showed serotypes diverse and much higher degree of genetic diversity, indicating that they are an unrelated group. More than 50% of isolates were resistant to at least 7 of the antimicrobials tested. Antibiotic-tolerant cells were observed, presenting with more frequency in response chloramphenicol, tetracycline, trimethoprim-sulfometoxazole and dicloxicillin. Conclusions: Persister cells can be detected from the beginning of the infection. The importance of these persister cells that exhibit multidrug tolerance is that a single surviving bacterium can initiate again an infection making it clinical relevant in the chronic urinary tract infection.

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Section: Discussionmentioning

confidence: 99%

UPEC strain characterization isolated from Mexican patients with recurrent urinary infections

Morales-Espinosa

Hernández‐Castro

Delgado

et al. 2016

J Infect Dev Ctries

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“…In the 2006 study, it was found that CTX-M-15 had joined CTX-M-14, SHV-12, and CTX-M-9 as a prevalent ESBL type. Thus, the predominant ESBL type had changed quickly, primarily due to the introduction and dissemination of a single clonal group characterized by CTX-M-15, serotype O25b: H4, phylogenetic group B2, and sequence type 131 (ST131), i.e., the international O25b:H4-B2-ST131 clonal group (5)(6)(7)(8)(9).…”

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Four Main Virotypes among Extended-Spectrum-β-Lactamase-Producing Isolates of Escherichia coli O25b:H4-B2-ST131: Bacterial, Epidemiological, and Clinical Characteristics

et al. 2013

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“…The second objective was to assess the association of particular CTX-M enzymes with the clonal background of strains. The third objective was to compare the distribution of the ST131 isolates with that of the non-ST131 isolates with regard to medical wards, clinical samples, and antibiotic susceptibility in order to better understand the epidemiology of this prevalent clone that often produces CTX-M-15 enzymes (1,6,7,11,15,25,26,30). …”

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confidence: 99%

Phylogenetic Distribution of CTX-M- and Non-Extended-Spectrum-β-Lactamase-Producing Escherichia coli Isolates: Group B2 Isolates, Except Clone ST131, Rarely Produce CTX-M Enzymes

et al. 2012

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i Escherichia coli is the species most frequently associated with clinical infections by extended-spectrum-␤-lactamase (ESBL)-producing isolates, with the CTX-M ESBL enzymes being predominant and found in genetically diverse E. coli isolates. The main objective of this study was to compare, on the basis of a case-control design, the phylogenetic diversity of 152 CTX-M-producing and 152 non-ESBL-producing clinical E. coli isolates. Multilocus sequence typing revealed that even though CTX-M enzymes were largely disseminated across the diversity of E. coli isolates, phylogenetic group B2 showed a particularly heterogeneous situation. First, clone ST131 of group B2 was strongly associated with CTX-M production (55 [79%] of 70 isolates), with CTX-M-15 being predominant. Second, the remaining members of group B2 were significantly less frequently associated with CTX-M production (9 [12%] of 75) than E. coli phylogenetic groups A, B1, and D (88 [55%] of 159). CTX-M-producing ST131 E. coli isolates were significantly more frequent in patients hospitalized in geriatric wards or long-term care facilities. Besides, the non-ESBL ST131 isolates significantly more frequently showed resistance to penicillins than the non-ESBL, non-ST131 isolates did. In conclusion, the present study emphasizes the particular antimicrobial resistance and epidemiologic characteristics of clone ST131 within group B2, which could result from the higher antibiotic exposure of this clone, as it is the predominant clone of group B2 carried in the human gut. E scherichia coli is the Enterobacteriaceae species that causes the largest number of infections, but this species is also a widespread gut commensal of humans and animals. Strains of E. coli are therefore frequently exposed to antimicrobial agents, which has resulted in the emergence and rapid diffusion of antibioticresistant E. coli clinical isolates. Extended-spectrum ␤-lactamases (ESBLs), which confer resistance to extended-spectrum cephalosporins, were, until the year 2000, produced essentially by Klebsiella pneumoniae and Enterobacter sp. isolates responsible for nosocomial infections. However, E. coli has become dominant among the ESBL-producing enterobacterial species. This is especially worrisome as the human gut carriage of E. coli favors the dissemination of ESBLs in the community (31). Interestingly, the switch of dominant species among the ESBL-producing enterobacterial isolates occurred concomitantly with the emergence of novel ESBL enzymes that belong to the CTX-M family. The CTX-M enzymes have superseded the TEM and SHV ESBLs (2) and are found in genetically diverse E. coli isolates. Among CTX-M enzymes, CTX-M-15 predominates and has been associated with the dissemination of a particular E. coli clone of sequence type 131 (ST131) (23,27).The species E. coli is genetically diverse, and strains have been classified into a number of phylogenetic groups, the most frequent ones being A, B1, B2, and D (12, 14, 29, 32). The ST131 clone belongs to phylogenetic group B2 and is associated wi...

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National survey of Escherichia coli causing extraintestinal infections reveals the spread of drug-resistant clonal groups O25b:H4-B2-ST131, O15:H1-D-ST393 and CGA-D-ST69 with high virulence gene content in Spain

Cited by 119 publications

References 33 publications

UPEC strain characterization isolated from Mexican patients with recurrent urinary infections

UPEC strain characterization isolated from Mexican patients with recurrent urinary infections

Four Main Virotypes among Extended-Spectrum-β-Lactamase-Producing Isolates of Escherichia coli O25b:H4-B2-ST131: Bacterial, Epidemiological, and Clinical Characteristics

Phylogenetic Distribution of CTX-M- and Non-Extended-Spectrum-β-Lactamase-Producing Escherichia coli Isolates: Group B2 Isolates, Except Clone ST131, Rarely Produce CTX-M Enzymes

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