Affiliation:
1. University of Minnesota, Minneapolis, Minnesota, USA
2. Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
Abstract
ABSTRACT
Emerging multidrug-resistant (MDR) Gram-negative bacilli (GNB), including
Escherichia coli
sequence type 131 (ST131) and its resistance-associated
H
30 subclone, constitute an ever-growing public health threat. Their reservoirs and transmission pathways are incompletely defined. To assess diarrheal stools as a potential reservoir for ST131-
H
30 and other MDR GNB, we cultured 100 clinical stool samples from a Veterans Affairs Medical Center clinical laboratory (October to December 2011) for fluoroquinolone- and extended-spectrum cephalosporin (ESC)-resistant
E. coli
and other GNB, plus total
E. coli
. We then characterized selected resistant and susceptible
E. coli
isolates by clonal group, phylogenetic group, virulence genotype, and pulsotype and screened all isolates for antimicrobial resistance. Overall, 79 of 100 stool samples yielded GNB (52
E. coli
; 48 other GNB). Fifteen samples yielded fluoroquinolone-resistant
E. coli
(10 were ST131, of which 9 were
H
30), 6 yielded ESC-resistant
E. coli
(2 were ST131, both non-
H
30), and 31 yielded susceptible
E. coli
(1 was ST131, non-
H
30), for 13 total ST131-positive samples. Fourteen non-
E. coli
GNB were ESC resistant, and three were fluoroquinolone resistant. Regardless of species, almost half (46%) of the fluoroquinolone-resistant and/or ESC-resistant non-
E. coli
GNB were resistant to at least three drug classes. Fecal ST131 isolates closely resembled reference clinical ST131 isolates according to virulence genotypes and pulsed-field gel electrophoresis (PFGE) profiles. Thus, a substantial minority (30%) of veterans with diarrhea who undergo stool testing excrete antibiotic-resistant GNB, including
E. coli
ST131. Consequently, diarrhea may pose transmission risks for more than just diarrheal pathogens and may help disseminate clinically relevant ST131 strains and other MDR GNB within hospitals and the community.
Funder
U.S. Department of Veterans Affairs
Publisher
American Society for Microbiology
Subject
Infectious Diseases,Pharmacology (medical),Pharmacology
Cited by
6 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献