ABSTRACT
This study provides the first description of healthcare-associated infections with Escherichia coli clonal group A (CgA) isolates in Latin America. Isolates were typed by enterobacterial repetitive intergenic consensus-PCR, pulsed-field gel electrophoresis, E. coli phylogenetic grouping, multilocus sequence typing and fimH single nucleotide polymorphism analysis. Out of 42 E. coli hospital isolates studied, three belonged to E. coli phylogenetic group D and ST69 and had fimH sequences identical to that of the CgA reference strain ATCC BAA-457. E. coli CgA is another potential source of resistant infections in hospitals.
Subject(s)
Urinary Tract Infections/microbiology , Uropathogenic Escherichia coli/isolation & purification , Bacterial Typing Techniques , Electrophoresis, Gel, Pulsed-Field , Female , Humans , Middle Aged , Phylogeny , Polymerase Chain Reaction , Uropathogenic Escherichia coli/classification , Uropathogenic Escherichia coli/geneticsABSTRACT
Recent studies from North America and Europe have demonstrated community-wide clonal spread of uropathogenic Escherichia coli (UPEC). To investigate if a similar pattern of spread occurs in Brazil, we characterized UPEC from women with community-acquired urinary tract infection (UTI) in Rio de Janeiro. E. coli isolates from women with UTI in one public outpatient clinic were evaluated for antibiotic susceptibility, E. coli phylogenetic grouping, enterobacterial repetitive intergenic consensus (ERIC) 2 PCR and pulsed-field gel electrophoresis fingerprinting, and multilocus sequence typing. From March 2005 to November 2006, 344 patients were studied. Of these, 186 (54%) had confirmed UTI, 118 (63.4%) of which were caused by E. coli. More than 50% of these isolates were resistant to ampicillin and trimethoprim/sulfamethoxazole. Of these, 96 (81%) belonged to 19 ERIC2 clonal groups. The largest group included 15 isolates, all belonging to multilocus sequence typing group ST69 and phylogenetic group D; they had pulsed-field gel electrophoresis patterns sharing at least 89% similarity compared with the CgA reference strain ATCC BAA-457. CgA strains have been found to be widespread in the United States in the early 2000s. Clonal group E. coli strains accounted for a large proportion (52%) of all UTIs and 82% of the trimethoprim/sulfamethoxazole-resistant E. coli UTIs. Thus, as in North America and Europe, UPECs that cause UTI in Rio de Janeiro also show clonal distribution, and a substantial proportion of drug-resistant UTI is caused by a small set of genetically related E. coli strains.
Subject(s)
Drug Resistance, Multiple, Bacterial , Escherichia coli Infections/microbiology , Urinary Tract Infections/microbiology , Uropathogenic Escherichia coli/genetics , Adolescent , Adult , Aged , Aged, 80 and over , Ampicillin/pharmacology , Anti-Bacterial Agents/pharmacology , Anti-Infective Agents, Urinary/pharmacology , Bacterial Typing Techniques , Brazil/epidemiology , Cross-Sectional Studies , Electrophoresis, Gel, Pulsed-Field , Escherichia coli Infections/epidemiology , Female , Humans , Middle Aged , Molecular Sequence Data , Prospective Studies , Trimethoprim, Sulfamethoxazole Drug Combination/pharmacology , Urinary Tract Infections/epidemiology , Uropathogenic Escherichia coli/classification , Uropathogenic Escherichia coli/isolation & purification , Young AdultABSTRACT
This study provides the first description of healthcare-associated infections with Escherichia coli clonal group A (CgA) isolates in Latin America. Isolates were typed by enterobacterial repetitive intergenic consensus-PCR, pulsed-field gel electrophoresis, E. coli phylogenetic grouping, multilocus sequence typing and fimH single nucleotide polymorphism analysis. Out of 42 E. coli hospital isolates studied, three belonged to E. coli phylogenetic group D and ST69 and had fimH sequences identical to that of the CgA reference strain ATCC BAA-457. E. coli CgA is another potential source of resistant infections in hospitals.
