Clinical and Molecular Epidemiology of Extended-Spectrum Beta-Lactamase-Producing Escherichia Coli Infections in Metro D
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BRIEF REPORT
Clinical and Molecular Epidemiology of ExtendedSpectrum Beta-Lactamase-Producing Escherichia Coli Infections in Metro Detroit: Early Dominance of the ST-131 Clone John P. Mills
. Keith S. Kaye . Richard Evans . Elizabeth Salzman .
Jason Pogue . Kayoko Hayakawa . Dror Marchaim . Pansy Awasthy . Madiha Salim . Emily T. Martin Received: May 27, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli infections have become endemic worldwide. We aimed to describe the molecular and clinical epidemiology of ESBL-producing E. coli infections during a period of rising global prevalence.
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12582083. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40121020-00321-6) contains supplementary material, which is available to authorized users. J. P. Mills (&) K. S. Kaye Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Health System, Ann Arbor, MI, USA e-mail: [email protected] K. S. Kaye R. Evans E. Salzman E. T. Martin Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA J. Pogue Department of Pharmacy, University of Michigan, Ann Arbor, MI, USA K. Hayakawa Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
Methods: Three hundred sixty-nine consecutive ESBL-producing E. coli infections in Detroit from 2010–2011 were analyzed. Sequence typing (ST) and CH typing were performed. Clinical characteristics and outcomes were compared between patients infected with ST131 and nonST131 isolates. Results: Ninety-six percent of isolates were ST 131, and 78.6% of ST 131 isolates produced blaCTX-M-15. Median time to effective therapy was 48 h vs. 35 h (P = 0.38) in the ST131 vs. non-ST131 groups. Ninety-day mortality rates (8% vs. 8%, P = 1.0) were similar between the two groups. Conclusion: blaCTX-M-15 ST131 E. coli predominated in Detroit during an early period of global ST131 dissemination. Patients with ST131 E. coli D. Marchaim Assaf Harofeh Medical Center, Zerifin and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel P. Awasthy Department of Pharmacy Services, Sinai-Grace Hospital, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA M. Salim Department of Medicine, Detroit Medical Center, Wayne State University, Detroit, MI, USA
Infect Dis Ther
infections had similar clinical outcomes to those with non-ST131 E. coli infections. Keywords: Escherichia coli; Extended spectrum beta-lactamase; Sequence typing Key Summary Points Extended-spectrum beta-lactamase (ESBL)producing E. coli are the most common cause of community-acquired multidrugresistant gram-negative bacterial infections. Dissemination of ESBL-producing E. coli has been driven by several factors, most notably the expansion of sequence type
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