Your browser doesn't support javascript.
loading
A one-year genomic investigation of Escherichia coli epidemiology and nosocomial spread at a large US healthcare network.
Mills, Emma G; Martin, Melissa J; Luo, Ting L; Ong, Ana C; Maybank, Rosslyn; Corey, Brendan W; Harless, Casey; Preston, Lan N; Rosado-Mendez, Joshua A; Preston, Scott B; Kwak, Yoon I; Backlund, Michael G; Bennett, Jason W; Mc Gann, Patrick T; Lebreton, Francois.
Afiliación
  • Mills EG; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
  • Martin MJ; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
  • Luo TL; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
  • Ong AC; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
  • Maybank R; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
  • Corey BW; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
  • Harless C; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
  • Preston LN; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
  • Rosado-Mendez JA; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
  • Preston SB; Department of Pathology, Walter Reed National Military Medical Center, Bethesda, MD, USA.
  • Kwak YI; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
  • Backlund MG; Department of Pathology, Walter Reed National Military Medical Center, Bethesda, MD, USA.
  • Bennett JW; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
  • Mc Gann PT; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA. patrick.t.mcgann4.civ@health.mil.
  • Lebreton F; Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, MD, USA. francois.lebreton.ctr@health.mil.
Genome Med ; 14(1): 147, 2022 12 30.
Article en En | MEDLINE | ID: mdl-36585742
ABSTRACT

BACKGROUND:

Extra-intestinal pathogenic Escherichia coli (ExPEC) are a leading cause of bloodstream and urinary tract infections worldwide. Over the last two decades, increased rates of antibiotic resistance in E. coli have been reported, further complicating treatment. Worryingly, specific lineages expressing extended-spectrum ß-lactamases (ESBLs) and fluoroquinolone resistance have proliferated and are now considered a serious threat. Obtaining contemporary information on the epidemiology and prevalence of these circulating lineages is critical for containing their spread globally and within the clinic.

METHODS:

Whole-genome sequencing (WGS), phylogenetic analysis, and antibiotic susceptibility testing were performed for a complete set of 2075 E. coli clinical isolates collected from 1776 patients at a large tertiary healthcare network in the USA between October 2019 and September 2020.

RESULTS:

The isolates represented two main phylogenetic groups, B2 and D, with six lineages accounting for 53% of strains ST-69, ST-73, ST-95, ST-131, ST-127, and ST-1193. Twenty-seven percent of the primary isolates were multidrug resistant (MDR) and 5% carried an ESBL gene. Importantly, 74% of the ESBL-E.coli were co-resistant to fluoroquinolones and mostly belonged to pandemic ST-131 and emerging ST-1193. SNP-based detection of possible outbreaks identified 95 potential transmission clusters totaling 258 isolates (12% of the whole population) from ≥ 2 patients. While the proportion of MDR isolates was enriched in the set of putative transmission isolates compared to sporadic infections (35 vs 27%, p = 0.007), a large fraction (61%) of the predicted outbreaks (including the largest cluster grouping isolates from 12 patients) were caused by the transmission of non-MDR clones.

CONCLUSION:

By coupling in-depth genomic characterization with a complete sampling of clinical isolates for a full year, this study provides a rare and contemporary survey on the epidemiology and spread of E. coli in a large US healthcare network. While surveillance and infection control efforts often focus on ESBL and MDR lineages, our findings reveal that non-MDR isolates represent a large burden of infections, including those of predicted nosocomial origins. This increased awareness is key for implementing effective WGS-based surveillance as a routine technology for infection control.
Asunto(s)
Palabras clave
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Infección Hospitalaria / Infecciones por Escherichia coli Tipo de estudio: Prognostic_studies / Qualitative_research / Risk_factors_studies / Screening_studies Límite: Humans Idioma: En Revista: Genome Med Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Infección Hospitalaria / Infecciones por Escherichia coli Tipo de estudio: Prognostic_studies / Qualitative_research / Risk_factors_studies / Screening_studies Límite: Humans Idioma: En Revista: Genome Med Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos