Colonisation dynamics and virulence of two clonal groups of multidrug-resistant Escherichia coli isolated from dogs.

The study established the virulence potential of multidrug-resistant Escherichia coli (MDREC) isolates from nosocomial infections in hospitalised dogs. The isolates were resistant to fluoroquinolones, belonged to two distinct clonal groups (CG1 and CG2) and contained a plasmid-mediated AmpC (CMY-7) beta-lactamase. CG1 isolates (n=14) possessed two of 36 assayed extraintestinal virulence genes (iutA and traT) and belonged to phylogenetic group A, whereas CG2 isolates (n=19) contained four such genes (iutA, ibeA, fimH and kpsMT K5) and belonged to group D. In a mouse gastrointestinal tract colonisation model, colonisation by index CG1 strain C1 was transient, in contrast to the index CG2 strain C2b, which persisted up to 40days post-inoculation. In a mouse subcutaneous challenge model, both strains were less virulent than archetypal group B2 extraintestinal pathogenic E. coli (ExPEC) strain CFT073; strain C1 caused no systemic signs and strain C2b was lethal to only one of six mice. In a mouse urinary tract infection model, strain C2b colonised the mouse bladder over 2 logs higher compared to strain C1. Whilst both groups of canine MDREC appear less virulent than a reference human ExPEC strain, CG2 strains have greater capacity for colonisation and virulence.

Emergence and spread of two distinct clonal groups of multidrug-resistant Escherichia coli in a veterinary teaching hospital in Australia.

Multidrug-resistant Escherichia coli (MDREC) expressing AmpC beta-lactamases have emerged as a cause of opportunistic infections in dogs. Following a cluster of extraintestinal infections caused by two distinct clonal groups (CGs) of bla(CMY)-producing MDREC, a 12-month infection control study was undertaken at a veterinary teaching hospital in Brisbane, Australia. Swabs from the rectum of hospitalized dogs (n=780), hospital staff (n=16) and the hospital environment (n=220) were plated onto selective agar to obtain multidrug-resistant (MDR) coliforms. These were then tested by multiplex PCR for E. coli uspA, bla(CMY) and the class 1 integron-associated dfrA17-aadA5 gene cassette for rapid identification of MDREC CG 1 (positive for all three genes) and CG 2 (positive for uspA and bla(CMY) only). A total of 16.5 % of the dog rectal swabs and 4.1% of the hospital environmental swabs yielded MDREC, and on the basis of multiplex PCR, PFGE and plasmid profiling, these were confirmed to belong to either CG 1 or CG 2. Both CG 1 and CG 2 isolates were obtained from clinical cases of extraintestinal infection and rectal swabs from hospitalized dogs over the same period of time, whereas only CG 1 isolates were obtained from the hospital environment. Both CGs were prevalent during the first 6 months, but only CG 2 was isolated during the second 6 months of the study. Two isolates obtained from rectal swabs of staff working in the hospital belonged to CG 2, with one of the isolates possessing the same REDP as nine isolates from dogs, including six isolates associated with cases of extraintestinal infection. CG 1 isolates belonged to E. coli serotypes O162 : H-, OR : H- or Ont : H-, whereas CG 2 isolates belonged to O153 : HR, OR : HR or OR : H34. These results confirm that in this particular outbreak, canine MDREC were highly clonal and CG 2 MDREC may colonize both humans and dogs.

Comparison of virulence gene profiles of Escherichia coli strains isolated from healthy and diarrheic swine.

A combination of uni- and multiplex PCR assays targeting 58 virulence genes (VGs) associated with Escherichia coli strains causing intestinal and extraintestinal disease in humans and other mammals was used to analyze the VG repertoire of 23 commensal E. coli isolates from healthy pigs and 52 clinical isolates associated with porcine neonatal diarrhea (ND) and postweaning diarrhea (PWD). The relationship between the presence and absence of VGs was interrogated using three statistical methods. According to the generalized linear model, 17 of 58 VGs were found to be significant (P < 0.05) in distinguishing between commensal and clinical isolates. Nine of the 17 genes represented by iha, hlyA, aidA, east1, aah, fimH, iroN(E. coli), traT, and saa have not been previously identified as important VGs in clinical porcine isolates in Australia. The remaining eight VGs code for fimbriae (F4, F5, F18, and F41) and toxins (STa, STb, LT, and Stx2), normally associated with porcine enterotoxigenic E. coli. Agglomerative hierarchical algorithm analysis grouped E. coli strains into subclusters based primarily on their serogroup. Multivariate analyses of clonal relationships based on the 17 VGs were collapsed into two-dimensional space by principal coordinate analysis. PWD clones were distributed in two quadrants, separated from ND and commensal clones, which tended to cluster within one quadrant. Clonal subclusters within quadrants were highly correlated with serogroups. These methods of analysis provide different perspectives in our attempts to understand how commensal and clinical porcine enterotoxigenic E. coli strains have evolved and are engaged in the dynamic process of losing or acquiring VGs within the pig population.

Pathotypes and serogroups of enterotoxigenic Escherichia coli isolated from pre-weaning pigs in north Vietnam.

The contribution of enterotoxigenic Escherichia coli (ETEC) to pre-weaning diarrhoea was investigated over a 6 month period at five selected commercial piggeries (CPs) in north Vietnam with at least 100 sows each. Diarrhoea was found to affect 71.5% of the litters born during the period of study. Of 406 faecal specimens submitted for bacteriological culture, 200 (49.3%) yielded a heavy pure culture of E. coli and 126 (31%) were confirmed by PCR to carry at least one of eight porcine ETEC virulence genes. ETEC was responsible for 43% of cases of diarrhoea in neonatal pigs during the first 4 days of life and 23.9% of the remaining cases up until the age of weaning. Pathotypes were determined by PCR for the 126 ETEC isolates together with 44 ETEC isolates obtained from village pigs (VPs) raised by smallholder farmers. The CP isolates belonged to five pathotypes, four of which were also identified in VP isolates. Haemolytic serogroup O149 : K91 isolates that belonged to F4/STa/STb/LT were most commonly identified in both CPs (33% of isolates) and VPs (45.5%). Other combinations identified in both production systems included O64 (F5/STa), O101 (F4/STa/STb) and O-nontypable (F-/STb). A high proportion of CP isolates (22.3%) possessed all three enterotoxins (STa/STb/LT), lacked the genes for all five tested fimbriae (F4, F5, F6, F41 and F18) and belonged to serogroup O8. These unusual O8 F- isolates were haemolytic and were isolated from all ages of diarrhoeic piglets at each CP, suggesting that they have pathogenic potential.

Diversity analysis of commensal porcine Escherichia coli - associations between genotypes and habitat in the porcine gastrointestinal tract.

Diversity studies of enteric Escherichia coli have relied almost entirely on faecal isolations on the assumption that they are representative of flora found throughout the gastrointestinal tract. The authors have addressed this belief by analysing isolates obtained from the duodenum, ileum, colon and faeces of pigs. E. coli isolates were obtained from eight pigs and characterized using multi-locus enzyme electrophoresis and PCR-based screening for a range of factors thought to be associated with intestinal and extra-intestinal disease. There are four main genetic groups of commensal E. coli (A, B1, B2, D). Group A strains represented 76 % of the isolates from the duodenum, ileum and colon compared to 58 % of the strains isolated from faeces. A nested molecular analysis of variance based on the allozyme and virulence factor screening results showed that differences among individual pigs accounted for 6 % of the observed genetic diversity, whilst 27 % of the genetic variation could be explained by clonal composition differences among gut regions. Finally, the absence of virulence genes in these commensals indicates that they may be suitable as a probiotic consortium, particularly if they also display increased adherence to enterocytes and antagonistic activity against pathogenic strains of E. coli.

Canine model for investigating the impact of oral enrofloxacin on commensal coliforms and colonization with multidrug-resistant Escherichia coli.

A model was developed in dogs to determine the impact of oral enrofloxacin administration on the indigenous coliform population in the gastrointestinal tract and subsequent disposition to colonization by a strain of multidrug-resistant Escherichia coli (MDREC). Dogs given a daily oral dose of 5 mg enrofloxacin kg(-1) for 21 consecutive days showed a significant decline in faecal coliforms to levels below detectable limits by 72 h of administration. Subsequently, faecal coliforms remained suppressed throughout the period of enrofloxacin dosing. Upon termination of antibiotic administration, the number of excreted faecal coliforms slowly returned over an 8-day period, to levels comparable to those seen prior to antibiotic treatment. Enrofloxacin-treated dogs were more effectively colonized by MDREC, evidenced by a significantly increased count of MDREC in the faeces (7.1 +/- 1.5 log(10) g(-1)) compared with non-antibiotic-treated dogs (5.2 +/- 1.2; P = 0.003). Furthermore, antibiotic treatment also sustained a significantly longer period of MDREC excretion in the faeces (26.8 +/- 10.5 days) compared with animals not treated with enrofloxacin (8.5 +/- 5.4 days; P = 0.0215). These results confirm the importance of sustained delivery of an antimicrobial agent to maintain and expand the colonization potential of drug-resistant bacteria in vivo, achieved in part by reducing the competing commensal coliforms in the gastrointestinal tract to below detectable levels in the faeces. Without in vivo antimicrobial selection pressure, commensal coliforms dominated the gastrointestinal tract at the expense of the MDREC population. Conceivably, the model developed could be used to test the efficacy of novel non-antibiotic strategies aimed at monitoring and controlling gastrointestinal colonization by multidrug-resistant members of the Enterobacteriaceae that cause nosocomial infections.

Revisiting the "hygiene hypothesis" in gastrointestinal allergy.

The "hygiene hypothesis" in its original form hypothesized that infection in early childhood acquired through unhygienic contact with siblings or the mother may prevent the development of allergic disease. Several recent epidemiologic surveys showing an inverse relationship between the frequency of infectious disease and the incidence of allergic diseases lend support to this hypothesis. Allergen sensitization of the immune system can occur early in utero against a background of neonatal commitment to a Th2 immune response involving the production of Th2 cytokines (eg, interleukin (IL)-4, IL-5, IL-13) that are the principal mediators of allergic inflammation. Continued allergen exposure is associated with predominantly CD4+ Th2 cell proliferation but does not exclude a minor Th1 allergen-specific subpopulation that can be further expanded nonspecifically and polyclonally by microbial superantigens or as bystanders, by interferon-gamma (IFN-gamma) and IL-2 released from Th1 effectors responding to antigens associated with infectious pathogens. Th1 cytokines can also subvert allergen-specific Th2 lymphocytes to become allergen-specific Th1 cells-a process reminiscent of the increased tendency of the maturing immune system of growing adults to mount a Th1 response to some environmental and dietary antigens. Unlike Th2 cytokines, IFN-gamma and IL-2 inhibit B-cell production of IgE and, hence, delimit the capacity of mast cells to degranulate and release allergenic mediators. The ability of infectious agents through their danger signals to initiate a Th1 response that deviates the Th2 allergenic bias is the basis of the hygiene hypothesis.