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 ST131 isolates. CONCLUSIONS: ST131 is a dominant, antimicrobial-resistant clonal group associated with healthcare settings, elderly hosts, and persistent or recurrent symptoms.
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 ST131 isolates. CONCLUSIONS:ST131 is a dominant, antimicrobial-resistant clonal group associated with healthcare settings, elderly hosts, and persistent or recurrent symptoms.
Authors: David M Livermore; Rafael Canton; Marek Gniadkowski; Patrice Nordmann; Gian Maria Rossolini; Guillaume Arlet; Juan Ayala; Teresa M Coque; Izabela Kern-Zdanowicz; Francesco Luzzaro; Laurent Poirel; Neil Woodford Journal: J Antimicrob Chemother Date: 2006-12-06 Impact factor: 5.790
Authors: James R Johnson; Megan Menard; Brian Johnston; Michael A Kuskowski; Kim Nichol; George G Zhanel Journal: Antimicrob Agents Chemother Date: 2009-04-27 Impact factor: 5.191
Authors: Paul J Rooney; Maureen C O'Leary; Anne C Loughrey; Mark McCalmont; Brian Smyth; Philip Donaghy; Motasim Badri; Neil Woodford; Edi Karisik; David M Livermore Journal: J Antimicrob Chemother Date: 2009-06-23 Impact factor: 5.790
Authors: Caroline Vincent; Patrick Boerlin; Danielle Daignault; Charles M Dozois; Lucie Dutil; Chrissi Galanakis; Richard J Reid-Smith; Pierre Paul Tellier; Patricia A Tellis; Kim Ziebell; Amee R Manges Journal: Emerg Infect Dis Date: 2010-01 Impact factor: 6.883
Authors: James R Johnson; Stephen B Porter; Paul Thuras; Timothy J Johnson; Lance B Price; Veronika Tchesnokova; Evgeni V Sokurenko Journal: Antimicrob Agents Chemother Date: 2015-08-31 Impact factor: 5.191
Authors: Julia J van Rensburg; Kate R Fortney; Lan Chen; Andrew J Krieger; Bruno P Lima; Alan J Wolfe; Barry P Katz; Zhong-Yin Zhang; Stanley M Spinola Journal: Antimicrob Agents Chemother Date: 2015-04-13 Impact factor: 5.191
Authors: Lana Dbeibo; Julia J van Rensburg; Sara N Smith; Kate R Fortney; Dharanesh Gangaiah; Hongyu Gao; Juan Marzoa; Yunlong Liu; Harry L T Mobley; Stanley M Spinola Journal: Infect Immun Date: 2018-02-20 Impact factor: 3.441
Authors: Ansal Shah; Julie Ann Justo; P Brandon Bookstaver; Joseph Kohn; Helmut Albrecht; Majdi N Al-Hasan Journal: Antimicrob Agents Chemother Date: 2017-04-24 Impact factor: 5.191
Authors: Timothy J Johnson; Ehud Elnekave; Elizabeth A Miller; Jeannette Munoz-Aguayo; Cristian Flores Figueroa; Brian Johnston; Daniel W Nielson; Catherine M Logue; James R Johnson Journal: Antimicrob Agents Chemother Date: 2018-12-21 Impact factor: 5.191
Authors: Theresa Madigan; James R Johnson; Connie Clabots; Brian D Johnston; Stephen B Porter; Billie S Slater; Ritu Banerjee Journal: Clin Infect Dis Date: 2015-03-31 Impact factor: 9.079
Authors: Namisha Singh; Sonja Gandhi; Eric McArthur; Louise Moist; Arsh K Jain; Aiden R Liu; Manish M Sood; Amit X Garg Journal: CMAJ Date: 2015-04-27 Impact factor: 8.262
Authors: Benjamin A Rogers; Paul R Ingram; Naomi Runnegar; Matthew C Pitman; Joshua T Freeman; Eugene Athan; Sally M Havers; Hanna E Sidjabat; Mark Jones; Earleen Gunning; Mary De Almeida; Kaylene Styles; David L Paterson Journal: Antimicrob Agents Chemother Date: 2014-01-27 Impact factor: 5.191