BACKGROUND: Extended-spectrum β-lactamase-producing Escherichia coli isolates (ESBL-E coli) cause more than 5000 cases of bacteraemias annually in the UK. The contribution of the food chain to these infections is debated. We aimed to identify the most important reservoirs of ESBL-E coli that colonise and infect humans to identify strategic intervention points. METHODS: Sampling for ESBL-E coli was done between Aug 1, 2013, and Dec 15, 2014. We used selective media to seek ESBL-E coli in routinely submitted samples from human faeces, and prospectively collected samples from sewage, farm slurry, and retail foodstuffs in London, East Anglia, northwest England, Scotland, and Wales. We sequenced recovered isolates and compared these isolates with 293 bloodstream and 83 veterinary surveillance ESBL-E coli isolates from the same regions. FINDINGS: 2157 (11%) of 20 243 human faeces samples contained ESBL-E coli, including 678 (17%) of 3995 in London. ESBL-E coli also were frequent in sewage and retail chicken (104 [65%] of 159 meat samples), but were rare in other meats and absent from plant-based foods (0 of 400 fruit and vegetable samples). Sequence type (ST) 131 dominated among ESBL-E coli from human blood (188 [64%] of 293 isolates), faeces (128 [36%] of 360), and sewage (14 [22%] of 65) with STs 38 and 648 also widespread; CTX-M-15 was the predominant ESBL in these lineages (319 [77%] of 416). By contrast, STs 602, 23, and 117-mostly with CTX-M-1 ESBL-dominated among food and veterinary isolates (68 [31%] of 218), with only two ST131 organisms recovered. ST10 occurred in both animals and humans, being frequent in surveillance bovines (11 [22%] of 51 cattle) and representing 15 (4%) of 360 human faecal isolates (but only three [1%] of 293 from bacteraemias); however, both human and animal ST10 isolates were diverse in serotype. INTERPRETATION: Most human bacteraemias with ESBL-E coli in the UK involve internationally prevalent human-associated STs, particularly ST131; non-human reservoirs made little contribution to invasive human disease. Any interventions that seek to target food or livestock can affect the numbers of human infections caused by ESBL-E coli; prevention of the spread of resistant lineages among humans is more vital. FUNDING: NIHR Policy Research.
BACKGROUND: Extended-spectrum β-lactamase-producing Escherichia coli isolates (ESBL-E coli) cause more than 5000 cases of bacteraemias annually in the UK. The contribution of the food chain to these infections is debated. We aimed to identify the most important reservoirs of ESBL-E coli that colonise and infect humans to identify strategic intervention points. METHODS: Sampling for ESBL-E coli was done between Aug 1, 2013, and Dec 15, 2014. We used selective media to seek ESBL-E coli in routinely submitted samples from human faeces, and prospectively collected samples from sewage, farm slurry, and retail foodstuffs in London, East Anglia, northwest England, Scotland, and Wales. We sequenced recovered isolates and compared these isolates with 293 bloodstream and 83 veterinary surveillance ESBL-E coli isolates from the same regions. FINDINGS: 2157 (11%) of 20 243 human faeces samples contained ESBL-E coli, including 678 (17%) of 3995 in London. ESBL-E coli also were frequent in sewage and retail chicken (104 [65%] of 159 meat samples), but were rare in other meats and absent from plant-based foods (0 of 400 fruit and vegetable samples). Sequence type (ST) 131 dominated among ESBL-E coli from human blood (188 [64%] of 293 isolates), faeces (128 [36%] of 360), and sewage (14 [22%] of 65) with STs 38 and 648 also widespread; CTX-M-15 was the predominant ESBL in these lineages (319 [77%] of 416). By contrast, STs 602, 23, and 117-mostly with CTX-M-1 ESBL-dominated among food and veterinary isolates (68 [31%] of 218), with only two ST131 organisms recovered. ST10 occurred in both animals and humans, being frequent in surveillance bovines (11 [22%] of 51 cattle) and representing 15 (4%) of 360 human faecal isolates (but only three [1%] of 293 from bacteraemias); however, both human and animal ST10 isolates were diverse in serotype. INTERPRETATION: Most humanbacteraemias with ESBL-E coli in the UK involve internationally prevalent human-associated STs, particularly ST131; non-human reservoirs made little contribution to invasive human disease. Any interventions that seek to target food or livestock can affect the numbers of human infections caused by ESBL-E coli; prevention of the spread of resistant lineages among humans is more vital. FUNDING: NIHR Policy Research.
Authors: Nadezhda Duffy; Maria Karlsson; Hannah E Reses; Davina Campbell; Jonathan Daniels; Richard A Stanton; Sarah J Janelle; Kyle Schutz; Wendy Bamberg; Paulina A Rebolledo; Chris Bower; Rebekah Blakney; Jesse T Jacob; Erin C Phipps; Kristina G Flores; Ghinwa Dumyati; Hannah Kopin; Rebecca Tsay; Marion A Kainer; Daniel Muleta; Benji Byrd-Warner; Julian E Grass; Joseph D Lutgring; J Kamile Rasheed; Christopher A Elkins; Shelley S Magill; Isaac See Journal: Infect Control Hosp Epidemiol Date: 2022-02-14 Impact factor: 6.520
Authors: Andrew Cameron; Rupinder Mangat; Heba H Mostafa; Samantha Taffner; Jun Wang; Ghinwa Dumyati; Richard A Stanton; Jonathan B Daniels; Davina Campbell; Joseph D Lutgring; Nicole D Pecora Journal: Antimicrob Agents Chemother Date: 2021-06-17 Impact factor: 5.191
Authors: Patrick da Silva; Bruna C Lustri; Ivana Giovannetti Castilho; Adriano Martison Ferreira; Rodrigo T Hernandes; Mark A Schembri; Cristiano G Moreira Journal: Braz J Microbiol Date: 2021-06-08 Impact factor: 2.214
Authors: Konstantinos Koutsoumanis; Ana Allende; Avelino Álvarez-Ordóñez; Declan Bolton; Sara Bover-Cid; Marianne Chemaly; Robert Davies; Alessandra De Cesare; Lieve Herman; Friederike Hilbert; Roland Lindqvist; Maarten Nauta; Giuseppe Ru; Marion Simmons; Panagiotis Skandamis; Elisabetta Suffredini; Héctor Argüello; Thomas Berendonk; Lina Maria Cavaco; William Gaze; Heike Schmitt; Ed Topp; Beatriz Guerra; Ernesto Liébana; Pietro Stella; Luisa Peixe Journal: EFSA J Date: 2021-06-17