Prevalence and transmission dynamics of Escherichia coli ST131 among contacts of infected community and hospitalized patients
Male
0301 basic medicine
Cross Infection
0303 health sciences
ST131
Intestinal persistence
Microbial Sensitivity Tests
Intestinal carriage
3. Good health
Community-Acquired Infections
Hospitalization
Feces
03 medical and health sciences
Spain
Drug Resistance, Multiple, Bacterial
Urinary Tract Infections
Escherichia coli
Prevalence
Humans
Female
Longitudinal Studies
Horizontal transmission
Escherichia coli Infections
DOI:
10.1016/j.cmi.2017.09.007
Publication Date:
2017-09-20T11:02:25Z
AUTHORS (6)
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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CITATIONS (16)
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