Extensive household outbreak of urinary tract infection and intestinal colonization due to extended-spectrum β-lactamase-producing Escherichia coli sequence type 131

Theresa Madigan, James R. Johnson, Connie Clabots, Brian D. Johnston, Stephen B. Porter, Billie S. Slater, Ritu Banerjee

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Reasons for the successful global dissemination of multidrug-resistant Escherichia coli sequence type 131 (ST131) are undefined, but may include enhanced transmissibility or ability to colonize the intestine compared with other strains. Methods: We identified a household in which 2 young children had urinary tract infection (UTI) caused by an extended-spectrum β-lactamase (ESBL)-producing, multidrug-resistant ST131 E. coli strain. We assessed the prevalence of ST131 intestinal colonization among the 7 household members (6 humans, 1 dog). Fecal samples, collected 3 times over a 19-week period, were cultured selectively for E. coli. Isolates were characterized using clone-specific polymerase chain reaction to detect ST131 and its ESBL-associated H30Rx subclone, pulsed-field gel electrophoresis, extended virulence genotyping, and antimicrobial susceptibility testing. Results: In total, 8 different E. coli pulsotypes (strains) were identified. The index patient's urine isolate represented ST131-H30Rx strain 903. This was the most widely shared and persistent strain in the household, colonizing 5 individuals at each sampling. In contrast, the 7 non-ST131 strains were each found in only 1 or 2 household members at a time, with variable persistence. The ST131 strain was the only strain with both extensive virulence and antimicrobial resistance profiles. Conclusions: An ESBL-producing ST131-H30Rx strain caused UTI in 2 siblings, plus asymptomatic intestinal colonization in multiple other household members, and was the household's most extensively detected and persistent fecal E. coli strain. Efficient transmission and intestinal colonization may contribute to the epidemiologic success of the H30Rx subclone of E. coli ST131.

Original languageEnglish (US)
Pages (from-to)e5-e12
JournalClinical Infectious Diseases
Volume61
Issue number1
DOIs
StatePublished - Jul 1 2015

Fingerprint

Urinary Tract Infections
Disease Outbreaks
Escherichia coli
Virulence
Aptitude
Pulsed Field Gel Electrophoresis
Intestines
Siblings
Clone Cells
Urine
Dogs
Polymerase Chain Reaction

Keywords

  • E. coli
  • ESBL
  • ST131

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Extensive household outbreak of urinary tract infection and intestinal colonization due to extended-spectrum β-lactamase-producing Escherichia coli sequence type 131. / Madigan, Theresa; Johnson, James R.; Clabots, Connie; Johnston, Brian D.; Porter, Stephen B.; Slater, Billie S.; Banerjee, Ritu.

In: Clinical Infectious Diseases, Vol. 61, No. 1, 01.07.2015, p. e5-e12.

Research output: Contribution to journalArticle

Madigan, Theresa ; Johnson, James R. ; Clabots, Connie ; Johnston, Brian D. ; Porter, Stephen B. ; Slater, Billie S. ; Banerjee, Ritu. / Extensive household outbreak of urinary tract infection and intestinal colonization due to extended-spectrum β-lactamase-producing Escherichia coli sequence type 131. In: Clinical Infectious Diseases. 2015 ; Vol. 61, No. 1. pp. e5-e12.
@article{a4155ffbb0474173993efa985ff4e26a,
title = "Extensive household outbreak of urinary tract infection and intestinal colonization due to extended-spectrum β-lactamase-producing Escherichia coli sequence type 131",
abstract = "Background: Reasons for the successful global dissemination of multidrug-resistant Escherichia coli sequence type 131 (ST131) are undefined, but may include enhanced transmissibility or ability to colonize the intestine compared with other strains. Methods: We identified a household in which 2 young children had urinary tract infection (UTI) caused by an extended-spectrum β-lactamase (ESBL)-producing, multidrug-resistant ST131 E. coli strain. We assessed the prevalence of ST131 intestinal colonization among the 7 household members (6 humans, 1 dog). Fecal samples, collected 3 times over a 19-week period, were cultured selectively for E. coli. Isolates were characterized using clone-specific polymerase chain reaction to detect ST131 and its ESBL-associated H30Rx subclone, pulsed-field gel electrophoresis, extended virulence genotyping, and antimicrobial susceptibility testing. Results: In total, 8 different E. coli pulsotypes (strains) were identified. The index patient's urine isolate represented ST131-H30Rx strain 903. This was the most widely shared and persistent strain in the household, colonizing 5 individuals at each sampling. In contrast, the 7 non-ST131 strains were each found in only 1 or 2 household members at a time, with variable persistence. The ST131 strain was the only strain with both extensive virulence and antimicrobial resistance profiles. Conclusions: An ESBL-producing ST131-H30Rx strain caused UTI in 2 siblings, plus asymptomatic intestinal colonization in multiple other household members, and was the household's most extensively detected and persistent fecal E. coli strain. Efficient transmission and intestinal colonization may contribute to the epidemiologic success of the H30Rx subclone of E. coli ST131.",
keywords = "E. coli, ESBL, ST131",
author = "Theresa Madigan and Johnson, {James R.} and Connie Clabots and Johnston, {Brian D.} and Porter, {Stephen B.} and Slater, {Billie S.} and Ritu Banerjee",
year = "2015",
month = "7",
day = "1",
doi = "10.1093/cid/civ273",
language = "English (US)",
volume = "61",
pages = "e5--e12",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Extensive household outbreak of urinary tract infection and intestinal colonization due to extended-spectrum β-lactamase-producing Escherichia coli sequence type 131

AU - Madigan, Theresa

AU - Johnson, James R.

AU - Clabots, Connie

AU - Johnston, Brian D.

AU - Porter, Stephen B.

AU - Slater, Billie S.

AU - Banerjee, Ritu

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Background: Reasons for the successful global dissemination of multidrug-resistant Escherichia coli sequence type 131 (ST131) are undefined, but may include enhanced transmissibility or ability to colonize the intestine compared with other strains. Methods: We identified a household in which 2 young children had urinary tract infection (UTI) caused by an extended-spectrum β-lactamase (ESBL)-producing, multidrug-resistant ST131 E. coli strain. We assessed the prevalence of ST131 intestinal colonization among the 7 household members (6 humans, 1 dog). Fecal samples, collected 3 times over a 19-week period, were cultured selectively for E. coli. Isolates were characterized using clone-specific polymerase chain reaction to detect ST131 and its ESBL-associated H30Rx subclone, pulsed-field gel electrophoresis, extended virulence genotyping, and antimicrobial susceptibility testing. Results: In total, 8 different E. coli pulsotypes (strains) were identified. The index patient's urine isolate represented ST131-H30Rx strain 903. This was the most widely shared and persistent strain in the household, colonizing 5 individuals at each sampling. In contrast, the 7 non-ST131 strains were each found in only 1 or 2 household members at a time, with variable persistence. The ST131 strain was the only strain with both extensive virulence and antimicrobial resistance profiles. Conclusions: An ESBL-producing ST131-H30Rx strain caused UTI in 2 siblings, plus asymptomatic intestinal colonization in multiple other household members, and was the household's most extensively detected and persistent fecal E. coli strain. Efficient transmission and intestinal colonization may contribute to the epidemiologic success of the H30Rx subclone of E. coli ST131.

AB - Background: Reasons for the successful global dissemination of multidrug-resistant Escherichia coli sequence type 131 (ST131) are undefined, but may include enhanced transmissibility or ability to colonize the intestine compared with other strains. Methods: We identified a household in which 2 young children had urinary tract infection (UTI) caused by an extended-spectrum β-lactamase (ESBL)-producing, multidrug-resistant ST131 E. coli strain. We assessed the prevalence of ST131 intestinal colonization among the 7 household members (6 humans, 1 dog). Fecal samples, collected 3 times over a 19-week period, were cultured selectively for E. coli. Isolates were characterized using clone-specific polymerase chain reaction to detect ST131 and its ESBL-associated H30Rx subclone, pulsed-field gel electrophoresis, extended virulence genotyping, and antimicrobial susceptibility testing. Results: In total, 8 different E. coli pulsotypes (strains) were identified. The index patient's urine isolate represented ST131-H30Rx strain 903. This was the most widely shared and persistent strain in the household, colonizing 5 individuals at each sampling. In contrast, the 7 non-ST131 strains were each found in only 1 or 2 household members at a time, with variable persistence. The ST131 strain was the only strain with both extensive virulence and antimicrobial resistance profiles. Conclusions: An ESBL-producing ST131-H30Rx strain caused UTI in 2 siblings, plus asymptomatic intestinal colonization in multiple other household members, and was the household's most extensively detected and persistent fecal E. coli strain. Efficient transmission and intestinal colonization may contribute to the epidemiologic success of the H30Rx subclone of E. coli ST131.

KW - E. coli

KW - ESBL

KW - ST131

UR - http://www.scopus.com/inward/record.url?scp=84953887912&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84953887912&partnerID=8YFLogxK

U2 - 10.1093/cid/civ273

DO - 10.1093/cid/civ273

M3 - Article

C2 - 25828998

AN - SCOPUS:84953887912

VL - 61

SP - e5-e12

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 1

ER -