Ahead of Print -Global Incidence of Carbapenemase-Producing Escherichia coli ST131 - Volume 20, Number 11—November 2014 - Emerging Infectious Disease journal - CDC

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Ahead of Print -Global Incidence of Carbapenemase-Producing Escherichia coli ST131 - Volume 20, Number 11—November 2014 - Emerging Infectious Disease journal - CDC

Volume 20, Number 11—November 2014

Dispatch

Global Incidence of Carbapenemase-Producing Escherichia coli ST131

On This Page

• The Study
• Conclusions
• Suggested Citation

Tables

• Table 1
• Table 2
• Table 3

Technical Appendicies

• Technical Appendix

Gisele Peirano, Patricia A. Bradford, Krystyna M. Kazmierczak, Robert E. Badal, Meredith Hackel, Daryl J. Hoban, and Johann D.D. Pitout 

Author affiliations: University of Calgary Faculty of Medicine, Calgary, Alberta, Canada (G. Peirano, J.D.D. Pitout); AstraZeneca Pharmaceuticals LP, Waltham, Massachusetts, USA (P.A. Bradford); International Health Management Associates, Schaumburg, Illinois, USA (K.M. Kazmierczak, R.E. Badal, M. Hackel, D.J. Hoban)

Suggested citation for this article

Abstract

We characterized Escherichia coli ST131 isolates among 116 carbapenemase-producing strains. Of isolates from 16 countries collected during 2008–2013, 35% belonged to ST131 and were associated with blaKPC,H30 lineage, and virotype C. This study documents worldwide incidents of resistance to “last resort” antimicrobial drugs among a common pathogen in a successful sequence type.

Escherichia coli sequence type 131 (ST131) was identified as pathogenic to humans in 2008; retrospective research suggests that its isolates have been present since at least 2003. The group has spread extensively and has been linked to the rapid global increase in the prevalence of antimicrobial resistance among E. coli strains (1). The intercontinental dissemination of this sequence type has contributed immensely to the worldwide emergence of fluoroquinolone-resistant and CTX-M–producing E. coli (1,2). Recent surveillance studies have shown that its overall prevalence ranges from 12.5% to 30% of all E. coli clinical isolates, from 70% to 80% of fluoroquinolone-resistant isolates, and from 50%to 60% of extended spectrum beta-lactamase-producing isolates (3).

The development of resistance to carbapenems among E. coli is of particular concern because these agents are often the last line of effective therapy available for the treatment of persons with serious infections (4). New Delhi metallo-β-lactamase (NDM) and carbapenem-hydrolyzing oxacillinase-48 (OXA-48) are the most common carbapenemases among E. coli worldwide (5).

Dr Peirano is a research associate at Calgary Laboratory Services and the University of Calgary. Her main research interests are related to the detection and molecular epidemiology of antimicrobial drug resistance mechanisms among Gram-negative bacteria.

Acknowledgments

This work was supported by a research grant from the Calgary Laboratory Services (#10006465).

J.D.D.P. had previously received research funds from Merck and Astra Zeneca. PAB is an employee of Astra Zeneca. K.M.K., R.E.B., M.H. and D.J.H. are employees of International Health Management Associates, which is under contract by Merck and AstraZeneca.

References

1. Nicolas-Chanoine MH, Bertrand X, Madec JY. Escherichia coli ST131, an intriguing clonal group. Clin Microbiol Rev. 2014;27:543–74.DOIPubMed
2. Peirano G, Pitout JD. Molecular epidemiology of Escherichia coli producing CTX-M β-lactamases: the worldwide emergence of clone ST131 O25:H4.Int J Antimicrob Agents. 2010;35:316–21. DOIPubMed
3. Banerjee R, Johnson JR. A new clone sweeps clean: the enigmatic emergence of Escherichia coli sequence type 131. Antimicrob Agents Chemother.2014;58:4997–5004. DOIPubMed
4. Pitout JD. Extraintestinal pathogenic Escherichia coli: an update on antimicrobial resistance, laboratory diagnosis and treatment. Expert Rev Anti Infect Ther. 2012;10:1165–76. DOIPubMed
5. Nordmann P, Poirel L. The difficult-to-control spread of carbapenemase producers in Enterobacteriaceae worldwide. Clin Microbiol Infect. 2014;06: .DOIPubMed
6. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Twenty-third Informational Supplements. M100–S23. Wayne (PA): The Institute; 2013. .
7. Lascols C, Peirano G, Hackel M, Laupland KB, Pitout JD. Surveillance and molecular epidemiology of Klebsiella pneumoniae isolates that produce carbapenemases: first report of OXA-48-like enzymes in North America. Antimicrob Agents Chemother. 2013;57:130–6. DOIPubMed
8. Lascols C, Hackel M, Marshall SH, Hujer AM, Bouchillon S, Badal R, Increasing prevalence and dissemination of NDM-1 metallo-β-lactamase in India: data from the SMART study (2009). J Antimicrob Chemother. 2011;66:1992–7. DOIPubMed
9. Banerjee R, Robicsek A, Kuskowski MA, Porter S, Johnston BD, Sokurenko E, Molecular epidemiology of Escherichia coli sequence type 131 and ItsH30 and H30-Rx subclones among extended-spectrum-β-lactamase-positive and -negative E. coli clinical isolates from the Chicago Region, 2007 to 2010. Antimicrob Agents Chemother. 2013;57:6385–8. DOIPubMed
10. Johnson JR, Clermont O, Johnston B, Clabots C, Tchesnokova V, Sokurenko E, Rapid and specific detection, molecular epidemiology, and experimental virulence of the O16 subgroup within Escherichia coli sequence type 131. J Clin Microbiol. 2014;52:1358–65. DOIPubMed
11. Johnson JR, Tchesnokova V, Johnston B, Clabots C, Roberts PL, Billig M, Abrupt emergence of a single dominant multidrug-resistant strain ofEscherichia coli. J Infect Dis. 2013;207:919–28. DOIPubMed
12. Blanco J, Mora A, Mamani R, Lopez C, Blanco M, Dahbi G, Four main virotypes among extended-spectrum-β-lactamase-producing isolates ofEscherichia coli O25b:H4–B2-ST131: bacterial, epidemiological, and clinical characteristics. J Clin Microbiol. 2013;51:3358–67. DOIPubMed
13. Cai JC, Zhang R, Hu YY, Zhou HW, Chen GX. Emergence of Escherichia coli sequence type 131 isolates producing KPC-2 carbapenemase in China.Antimicrob Agents Chemother. 2014;58:1146–52. DOIPubMed
14. O'Hara JA, Hu F, Ahn C, Nelson J, Rivera JI, Pasculle AW, Molecular epidemiology of KPC-producing Escherichia coli: occurrence of ST131-fimH30 subclone harboring pKpQIL-like IncFIIk plasmid. Antimicrob Agents Chemother. 2014;58:4234–7 . DOIPubMed
15. Price LB, Johnson JR, Aziz M, Clabots C, Johnston B, Tchesnokova V, The epidemic of extended-spectrum-beta-lactamase–producing Escherichia coli ST131 is driven by a single highly pathogenic subclone, H30-Rx. MBio. 2013;4:e00377–13. DOIPubMed

Tables

• Table 1. Antimicrobial drug susceptibilities, β-lactamase types, fimH30 lineage, and different virotypes of Escherichia coli that have carbapenemases
• Table 2. Escherichia coli with carbapenemases from combined Merck Study for Monitoring Antimicrobial Resistance Trends and AstraZeneca surveillance programs
• Table 3. Temporal distribution of Escherichia coli ST131 in 2 global studies, 2008–2013

Technical Appendix

• Technical Appendix. A brief description is provided of antimicrobial resistance surveillance and molecular characterization programs by pharmaceutical companies Merck and AstraZeneca.  17 KB

Suggested citation for this article: Peirano G, Bradford PA, Kazmierczak KM, Badal RE, Hackel M, Hoban DJ, et al. Global incidence of carbapenemase-producing Escherichia coli ST131. Emerg Infect Dis. 2014 Nov [date cited]. http://dx.doi.org/10.3201/eid2011.141388

DOI: 10.3201/eid2011.141388

CrossRef reports the first page should be "e00377-13" not "e00377" in reference 15 "Price, Johnson, Aziz, Clabots, Johnston, Tchesnokova, et al., 2013".

Please verify the page numbers (e00377-13) (in reference 15 "Price, Johnson, Aziz, Clabots, Johnston, Tchesnokova, et al., 2013").

PRODUCTION NOTE: This table is online only.