Publication:
Prevalence and transmission dynamics of Escherichia coli ST131 among contacts of infected community and hospitalized patients.

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Date

2017-09-19

Authors

Torres, E
Lopez-Cerero, L
Morales, I
Navarro, M D
Rodriguez-Baño, J
Pascual, A

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Elsevier Ltd
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Abstract

The Escherichia coli O25b-associated ST131 clonal group was recently found to be prevalent in our area as a cause of community-acquired urinary tract infections. We evaluated the transmission dynamics and longitudinal persistence of E. coli O25b-ST131 between patients with nosocomial and community-acquired infections and their contacts. Prevalence and transmission of O25b/pabB3/B23 isolates were compared in 38 community clusters, 30 nosocomial clusters and 50 healthy volunteers. Duration of colonization was studied at 1 to 4 months and 6 to 12 months after the first sample. Isolates exhibiting a three-band or less difference by pulsed-field gel electrophoresis were assigned to the same pulsotype. Colonization was found to be more frequent in index cases (31/68, 45.6%) than in contacts (25/118, 21.2%; p 0.0009) or volunteers (1/50, 2%; p 0.0009). Seven (11%) of 64 isolates were extended-spectrum β-lactamase producers. Transmission occurred in 61% (8/13) community clusters and in 12% (1/8) nosocomial clusters. Thirteen (56.5%) of the 23 initial carriers assessed at 1 to 4 months remained colonized. Only 2 (13.3%) of 15 positive patients followed for 6 to 12 months showed prolonged carriage, and none was infected with extended-spectrum β-lactamase producers. Six previously positive individuals acquired a different ST131 pulsotype (5/23 at sample 2 and 1/15 at sample 3), and three previously negative individuals became positive (2/46 at 1-4 months and 1/33 at 6-12 months). Person-to-person transmission or acquisition from a common source of E. coli O25b-associated ST131 is more frequent in the household setting than in the nosocomial setting. The carrier state does not usually last beyond 4 months, with new acquisitions in certain individuals.

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MeSH Terms

Community-Acquired Infections
Cross Infection
Drug Resistance, Multiple, Bacterial
Escherichia coli
Escherichia coli Infections
Feces
Female
Hospitalization
Humans
Longitudinal Studies
Male
Microbial Sensitivity Tests
Prevalence
Spain
Urinary Tract Infections

DeCS Terms

Pacientes
Coliformes
Prevalencia
Portador sano
Escherichia coli
Infecciones urinarias
Infecciones comunitarias adquiridas

CIE Terms

Keywords

Escherichia coli, Horizontal transmission, Intestinal carriage, Intestinal persistence, ST131

Citation

Torres E, López-Cerero L, Morales I, Navarro MD, Rodríguez-Baño J, Pascual A. Prevalence and transmission dynamics of Escherichia coli ST131 among contacts of infected community and hospitalized patients. Clin Microbiol Infect. 2018 Jun;24(6):618-623.