Spread of Escherichia coli O25b:H4-B2-ST131 producing CTX-M-15 and SHV-12 with high virulence gene content in Barcelona (Spain)

Coelho, Alicia; Mora, Azucena; Mamani, Rosalía; López, Cecilia; González-López, Juan José; Larrosa, Nieves; Quintero-Zárate, J. Natalia; Dahbi, Ghizlane; Herrera, Alexandra; Blanco, Jesús E.; Blanco, Miguel; Alonso, Marı́a Pilar; Prats, Guillem; Blanco, Jorge

doi:10.1093/jac/dkq491

Cited by 71 publications

(63 citation statements)

References 33 publications

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“…A similar fraction of ST131 among ESBL isolates was found in several international studies (24)(25)(26) and in a recent Danish study that, in contrast to our study, provided only limited characterization of the isolates (27).…”

Section: Discussionsupporting

confidence: 90%

Prevalence and Characteristics of the Epidemic Multiresistant Escherichia coli ST131 Clonal Group among Extended-Spectrum Beta-Lactamase-Producing E. coli Isolates in Copenhagen, Denmark

Olesen¹,

Hansen²,

Nilsson³

et al. 2013

J Clin Microbiol

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We report the characteristics of 115 extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli clinical isolates, from 115 unique Danish patients, over a 1-year study interval (1 October 2008 to 30 September 2009). Forty-four (38%) of the ESBL isolates represented sequence type 131 (ST13)1, from phylogenetic group B2. The remaining 71 isolates were from phylogenetic groups D (27%), A (22%), B1 (10%), and B2 (3%). Serogroup O25 ST131 isolates (n ‫؍‬ 42; 95% of ST131) comprised 7 different K antigens, whereas two ST131 isolates were O16:K100:H5. Compared to non-ST131 isolates, ST131 isolates were associated positively with CTX-M-15 and negatively with CTX-M-1 and CTX-M-14. They also were associated positively with 11 virulence genes, including afa and dra (Dr family adhesins), the F10 papA allele (P fimbria variant), fimH (type 1 fimbriae), fyuA (yersiniabactin receptor), iha (adhesin siderophore), iutA (aerobactin receptor), kpsM II (group 2 capsules), malX (pathogenicity island marker), ompT (outer membrane protease), sat (secreted autotransporter toxin), and usp (uropathogenicity-specific protein) and negatively with hra (heat-resistant agglutinin) and iroN (salmochelin receptor). The consensus virulence gene profile (>90% prevalence) of the ST131 isolates included fimH, fyuA, malX, and usp (100% each), ompT and the F10 papA allele (95% each), and kpsM II and iutA (93% each). ST131 isolates were also positively associated with community acquisition, extraintestinal pathogenic E. coli (ExPEC) status, and the O25, K100, and H4 antigens. Thus, among ESBL E. coli isolates in Copenhagen, ST131 was the most prevalent clonal group, was community associated, and exhibited distinctive and comparatively extensive virulence profiles, plus a greater variety of capsular antigens than reported previously. E scherichia coli is the most common agent of urinary tract infection (UTI) and Gram-negative bacteremia. E. coli sequence type 131 (ST131) is a recently emerged worldwide pandemic clonal group, causing widespread antimicrobial-resistant infections (1). Although many studies have examined various aspects of E. coli ST131 in diverse locales and clinical contexts (1, 2), little is known about ST131's O:K:H serotypes, especially in relation to community versus health care site of acquisition, coresistance phenotypes, extended-spectrum beta-lactamase (ESBL) variants, and pulse-field gel electrophoresis (PFGE) types. Such data are needed to more fully understand the epidemiology of ST131 and to help guide diagnostic and preventive efforts.CTX-M-type beta-lactamases have become the dominant ESBLs worldwide during the past decade (3). The responsible bla CTX-M genes are known to be associated with conjugative plasmids and certain successful bacterial clones, notably ST131 (4).Here we assessed the prevalence of E. coli ST131 among 115 consecutive ESBL-producing E. coli isolates from 115 patients (2008)(2009) from 3 hospitals and 100 general practitioners' offices in Copenhagen, Denmark. Subsequently, we compared ST131 and ...

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Section: Discussionsupporting

confidence: 90%

Prevalence and Characteristics of the Epidemic Multiresistant Escherichia coli ST131 Clonal Group among Extended-Spectrum Beta-Lactamase-Producing E. coli Isolates in Copenhagen, Denmark

Olesen¹,

Hansen²,

Nilsson³

et al. 2013

J Clin Microbiol

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“…This contrasts with the 9% prevalence of ST131 among the 92 analyzed ESBLEC isolates from a similar study from 2004 done in 11 Spanish hospitals (7 of which were included in the present study) (8). More recent studies found even higher prevalences of O25b-ST131 among ESBLECs in various Spanish cities, including Lugo in 2008 (23%) (5) and in 2012 (61%) (27), Barcelona (32% in 2008) (28), Seville (13% in 2010) (29), and Madrid (21% in 2008) (30). Other countries have also had high reported prevalences of ST131 among the ESBLEC strains, including Denmark (38%) (31), Japan (41%) (32), the United States (47%) (33), and Canada (78%) (34).…”

Section: Discussioncontrasting

confidence: 80%

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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“…In contrast, other studies have found that ST131 is not highly virulent in infection models and that it differs from classical ExPEC group B2 strains by the absence of several virulence genes, such as hlyA and cnf1 (38). It appears that few virulence genes are consistently present in this clone (39).…”

Section: Discussioncontrasting

confidence: 67%

Characterization of Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli Strains Involved in Maternal-Fetal Colonization: Prevalence of E. coli ST131

et al. 2013

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dMaternal-fetal Escherichia coli infections, such as neonatal bacteremia and meningitis, are important causes of morbidity and mortality. From 2006 to 2010, we studied newborns and their mothers who were colonized with E. coli in a French hospital in order to document (i) the epidemiology and genetic characteristics of extended-spectrum-beta-lactamase (ESBL)-producing E. coli strains, (ii) the prevalence of associated virulence genes, (iii) the prevalence of clone sequence type 131 (ST131), and (iv) the genetic relationship among ESBL-producing strains. Among the 2,755 E. coli cultures recovered from vaginal or neonatal samples, 68 were ESBL producers (2.46%). We found a wide diversity of ESBL genes, with the majority being bla CTX-M-14 , bla CTX-M-1 , and bla CTX-M-15 , distributed among the 4 main phylogenetic groups. Genes encoding virulence factors were found in 90.7% of the isolates, with >2 virulence genes present in 76% of cases. The prevalence of ST131 among ESBL-producing E. coli isolates was 9.4% (6/64). Five of these 6 ST131 isolates possessed bla CTX-M-15 enzymes (and also were resistant to quinolones), and one possessed bla CTX-M-2 enzymes. Two possessed virulence genes, suggesting the presence of pathogenicity island II J96 (PAI II J96 )-like domains. Pulsed-field gel electrophoresis (PFGE) revealed a high level of genomic diversity overall, except for 3 closely related isolates belonging to clonal group ST131. Repetitive PCR showed that the six ST131 isolates were closely related to ST131 control strains (>95% similarity). This study shows a high prevalence of ESBL-producing E. coli strains and clonal group ST131 in the French maternal-fetal population. These results suggest a widespread distribution of ESBL enzymes in the community and highlight the early transmission between mothers and neonates. These findings are worrisome, especially for this particularly vulnerable population. In the past decade, there has been an alarming increase in antibiotic-resistant Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBLs), due at least in part to the overuse of broad-spectrum cephalosporins.The majority of ESBLs identified in clinical isolates during the 1980s to 1990 were of the SHV or TEM type (1). However, since the mid-2000s, CTX-M ESBLs, originating from environmental Kluyvera spp., have gained prominence and are considered pandemic enzymes. CTX-M has been identified in several members of the Enterobacteriaceae family, and especially in Escherichia coli, which has replaced Klebsiella spp. as the principal ESBL-producing member of the Enterobacteriaceae (2-4).ESBL enzymes are important causes of cephalosporin treatment failure. E. coli strains carrying these enzymes were initially responsible mainly for nosocomial infections, but they have now disseminated into the community. One of the best examples of this trend is the global spread of E. coli clone sequence type 131 (ST131), expressing CTX-M enzymes (5). Maternal-fetal E. coli infections, such as neonatal bacteremia and meningitis,...

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Spread of Escherichia coli O25b:H4-B2-ST131 producing CTX-M-15 and SHV-12 with high virulence gene content in Barcelona (Spain)

Abstract: We report for the first time the clonal spread of SHV-12-producing O25b:H4-B2-ST131 isolates characterized by high virulence gene content. Moreover, we describe the distribution of the ST131 isolates within different virulence groups.

Cited by 71 publications

References 33 publications

Prevalence and Characteristics of the Epidemic Multiresistant Escherichia coli ST131 Clonal Group among Extended-Spectrum Beta-Lactamase-Producing E. coli Isolates in Copenhagen, Denmark

Prevalence and Characteristics of the Epidemic Multiresistant Escherichia coli ST131 Clonal Group among Extended-Spectrum Beta-Lactamase-Producing E. coli Isolates in Copenhagen, Denmark

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

Characterization of Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli Strains Involved in Maternal-Fetal Colonization: Prevalence of E. coli ST131

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