Whole-genome analysis of extraintestinal Escherichia coli sequence type 73 from a single hospital over a 2 year period identified different circulating clonal groups.

Sequence type (ST)73 has emerged as one of the most frequently isolated extraintestinal pathogenic Escherichia coli. To examine the localized diversity of ST73 clonal groups, including their mobile genetic element profile, we sequenced the genomes of 16 multiple-drug resistant ST73 isolates from patients with urinary tract infection from a single hospital in Sydney, Australia, between 2009 and 2011. Genome sequences were used to generate a SNP-based phylogenetic tree to determine the relationship of these isolates in a global context with ST73 sequences (n=210) from public databases. There was no evidence of a dominant outbreak strain of ST73 in patients from this hospital, rather we identified at least eight separate groups, several of which reoccurred, over a 2 year period. The inferred phylogeny of all ST73 strains (n=226) including the ST73 clone D i2 reference genome shows high bootstrap support and clusters into four major groups that correlate with serotype. The Sydney ST73 strains carry a wide variety of virulence-associated genes, but the presence of iss, pic and several iron-acquisition operons was notable.

Oral mucosal screening as an integral part of routine dental care.

The principal aim of this study was to assess the feasibility of conducting a systematic examination of the oral mucosa, as an integral part of the routine dental check-up and in conditions comparable with those in NHS dental practice. A total of 1949 individuals, who were already registered as patients with an industrial dental clinic, were invited to attend for an oral screen as part of their dental examination. Of these, 1947 patients agreed to participate and were also asked to complete a 'habits' questionnaire relating to their tobacco and alcohol use. A systematic examination of the oral mucosa was undertaken as part of the routine dental inspection and mucosal lesions were recorded as either a positive or negative screening result. Lesions included as a positive result were those which may be associated with early cancer or precancer. Four patients (0.2%) were considered to have a positive screening result and these were referred for specialist evaluation. Of these, two had tobacco-related leukoplakia, one had oral lichen planus and the other had an early squamous cell carcinoma. This study has confirmed that a systematic and thorough examination of the oral mucosa can realistically be carried out as part of the routine dental inspection in NHS dental practice.