Emergence of Escherichia coli Sequence Type 131 (ST131) and ST3948 with KPC-2, KPC-3 and KPC-8 carbapenemases from a Long-Term Care and Rehabilitation Facility (LTCRF) in Northern Italy

2015 ◽  
pp. 77-89 ◽  
Author(s):  
Aurora Piazza ◽  
Mariasofia Caltagirone ◽  
Ibrahim Bitar ◽  
Elisabetta Nucleo ◽  
Melissa Spalla ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Long Term Care ◽  
Northern Italy ◽  
Sequence Type ◽  
Term Care ◽  
Rehabilitation Facility

scholarly journals Escherichia coli Sequence Type 131 Is a Dominant, Antimicrobial-Resistant Clonal Group Associated with Healthcare and Elderly Hosts

2013 ◽  
Vol 34 (4) ◽  
pp. 361-369 ◽  
Author(s):  
Ritu Banerjee ◽  
Brian Johnston ◽  
Christine Lohse ◽  
Stephen B. Porter ◽  
Connie Clabots ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Long Term Care ◽  
Tertiary Care ◽  
Sequence Type ◽  
Olmsted County ◽  
Term Care ◽  
Clonal Group ◽  
E Coli ◽  
Healthcare Settings

Objective.To determine prevalence, predictors, and outcomes of infection due to Escherichia coli sequence type ST131.Design.Retrospective cohort.Setting.All healthcare settings in Olmsted County, Minnesota (eg, community hospital, tertiary care center, long-term care facilities, and ambulatory clinics).Patients.Ambulatory and hospitalized children and adults with extraintestinal E. coli isolates.Methods.We analyzed 299 consecutive, nonduplicate extraintestinal E. coli isolates submitted to Olmsted County laboratories in February and March 2011. ST131 was identified using single-nucleotide polymorphism polymerase chain reaction and further evaluated through pulsed-field gel electrophoresis. Associated clinical data were abstracted through medical record review.Results.Most isolates were from urine specimens (90%), outpatients (68%), and community-associated infections (61%). ST131 accounted for 27% of isolates overall and for a larger proportion of those isolates resistant to fluoroquinolones (81%), trimethoprim-sulfamethoxazole (42%), gentamicin (79%), and ceftriaxone (50%). The prevalence of ST131 increased with age (accounting for 5% of isolates from those 11–20 years of age, 26% of isolates from those 51–60 years of age, and 50% of isolates from those 91–100 years of age). ST131 accounted for a greater proportion of healthcare-associated isolates (49%) than community-associated isolates (15%) and for fully 76% of E. coli isolates from long-term care facility (LTCF) residents. Multivariable predictors of ST131 carriage included older age, LTCF residence, previous urinary tract infection, high-complexity infection, and previous use of fluoroquinolones, macrolides, and extended-spectrum cephalosporins. With multivariable adjustment, ST131-associated infection outcomes included receipt of more than 1 antibiotic (odds ratio [OR], 2.54 [95% confidence interval (CI), 1.25–5.17]) and persistent or recurrent symptoms (OR, 2.53 [95% CI, 1.08–5.96]). Two globally predominant ST131 pulsotypes accounted for 45% of STB 1 isolates.Conclusions.ST131isa dominant, antimicrobial-resistant clonal group associated with healthcare settings, elderly hosts, and persistent or recurrent symptoms.

scholarly journals Long-Term Care Facilities Are Reservoirs for Antimicrobial-Resistant Sequence Type 131 Escherichia coli

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Mary J. Burgess ◽  
James R. Johnson ◽  
Stephen B. Porter ◽  
Brian Johnston ◽  
Connie Clabots ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Gel Electrophoresis ◽  
Long Term Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Sequence Type ◽  
Term Care ◽  
E Coli ◽  
Care Facilities

Abstract Background.  Emerging data implicate long-term care facilities (LTCFs) as reservoirs of fluoroquinolone-resistant (FQ-R) Escherichia coli of sequence type 131 (ST131). We screened for ST131 among LTCF residents, characterized isolates molecularly, and identified risk factors for colonization. Methods.  We conducted a cross-sectional study using a single perianal swab or stool sample per resident in 2 LTCFs in Olmsted County, Minnesota, from April to July 2013. Confirmed FQ-R E. coli isolates underwent polymerase chain reaction-based phylotyping, detection of ST131 and its H30 and H30-Rx subclones, extended virulence genotyping, and pulsed-field gel electrophoresis (PFGE) analysis. Epidemiological data were collected from medical records. Results.  Of 133 fecal samples, 33 (25%) yielded FQ-R E. coli, 32 (97%) of which were ST131. The overall proportion with ST131 intestinal colonization was 32 of 133 (24%), which differed by facility: 17 of 41 (42%) in facility 1 vs 15 of 92 (16%) in facility 2 (P = .002). All ST131 isolates represented the H30 subclone, with virulence gene and PFGE profiles resembling those of previously described ST131 clinical isolates. By PFGE, certain isolates clustered both within and across LTCFs. Multivariable predictors of ST131 colonization included inability to sign consent (odds ratio [OR], 4.16 [P = .005]), decubitus ulcer (OR, 4.87 [ P = .04]), and fecal incontinence (OR, 2.59 [P = .06]). Conclusions.  Approximately one fourth of LTCF residents carried FQ-R ST131 E. coli resembling ST131 clinical isolates. Pulsed-field gel electrophoresis suggested intra- and interfacility transmission. The identified risk factors suggest that LTCF residents who require increased nursing care are at greatest risk for ST131 colonization, possibly due to healthcare-associated transmission.

scholarly journals The Niche for Escherichia coli Sequence Type 131 Among Veterans: Urinary Tract Abnormalities and Long-Term Care Facilities

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Dimitri M. Drekonja ◽  
Michael A. Kuskowski ◽  
Ruth Anway ◽  
Brian D. Johnston ◽  
James R. Johnson
Keyword(s):  
Escherichia Coli ◽  
Long Term Care ◽  
Severe Disease ◽  
Care Facility ◽  
Epidemiological Data ◽  
Initial Therapy ◽  
Sequence Type ◽  
Term Care ◽  
E Coli

Abstract Background.  Antimicrobial resistance among Escherichia coli is increasing, driven largely by the global emergence of sequence type 131 (ST131). However, the clinical significance of ST131 status is unknown. Among veterans, we assessed whether ST131 causes more severe, persistent, or recurrence-prone infections than non-ST131 E. coli. Methods.  Isolates were assessed by polymerase chain reaction for membership in ST131 and relevant subclones thereof (H30R and H30Rx) and by broth microdilution for susceptibility to 11 antibiotics. Clinical and epidemiological data were systematically abstracted from the medical record. Between-group comparisons were made using t tests and Fisher's exact test. Results.  Of the 311 unique E. coli isolates, 61 (19.6%) represented ST131. Of these, most (51 of 61, 83.6%) represented the H30R subclone; only 5 of 51 (9.8%) represented H30Rx. Relative to non-ST131 and non-H30R isolates, neither ST131 nor H30R were associated with more severe disease, worse clinical outcomes, or more robust hosts. Instead, both were more likely to be isolated from patients without manifestations of infection (for ST131, 36.1% vs 21.2% [P = .02]; for H30R, 39% vs 21% [P = .008]) and who had prior healthcare contact or long-term care facility (LTCF) exposure (for ST131, 33% vs 14% [P = .002]; for H30R, 37% vs 14% [P < .001]). Despite a greater likelihood of discordant initial therapy, outcomes did not differ between ST131 and H30R isolates vs other E. coli isolates. Conclusions.  Among veterans, ST131 and its H30R subclone were associated with LTCF-exposed hosts but not with worse outcomes.

scholarly journals Spread of CTX-M-type ESßLs in isolates of E. coli from long-term care and rehabilitation facilities in Northern Italy

2008 ◽  
Vol 23 (3) ◽  
Author(s):  
Elisabetta Nucleo ◽  
Roberta Migliavacca ◽  
Michela Balzaretti ◽  
Fabiola Martino ◽  
Melissa Spalla ◽  
...  
Keyword(s):  
Long Term Care ◽  
Northern Italy ◽  
Term Care ◽  
E Coli ◽  
Rehabilitation Facilities

scholarly journals Characterization of blaCTX-M-27/F1:A2:B20 Plasmids Harbored by Escherichia coli Sequence Type 131 Sublineage C1/H30R Isolates Spreading among Elderly Japanese in Nonacute-Care Settings

2020 ◽  
Vol 64 (5) ◽  
Author(s):  
Nao Matsuo ◽  
Rina Nonogaki ◽  
Michiko Hayashi ◽  
Jun-ichi Wachino ◽  
Masahiro Suzuki ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Care Facility ◽  
Sequence Type ◽  
Health Concern ◽  
Term Care ◽  
Content Type ◽  
Long Term Care Facility ◽  
Elderly Japanese

ABSTRACT We characterized 29 blaCTX-M-27-harboring plasmids of Escherichia coli sequence type 131 (ST131) sublineage C1/H30R isolates from healthy individuals and long-term-care facility (LTCF) residents. Most (27/29) plasmids were of the FIA, FIB, and FII multireplicon type with the same plasmid multilocus sequence typing (pMLST). Several plasmids (7/23) from LTCF residents harbored only blaCTX-M-27 as the resistance gene; however, their fundamental structures were very similar to those of previously isolated blaCTX-M-27/F1:A2:B20 plasmids, suggesting their prevalence as a newly arising public health concern.

Fluoroquinolone-Resistant Escherichia coli in the Long-Term Care Setting

2006 ◽  
Vol 119 (11) ◽  
pp. 958-963 ◽  
Author(s):  
Alana E. Cohen ◽  
Ebbing Lautenbach ◽  
Knashawn H. Morales ◽  
Darren R. Linkin
Keyword(s):  
Escherichia Coli ◽  
Care Setting ◽  
Long Term Care ◽  
Term Care
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