Abstract：
The global emergence of extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-E. coli), mainly causing urinary tract infections (UTI), is of great concern. Almost one third of patients with UTI, develop recurrent UTI (RUTI). We followed 297 patients for one year after their first episode of UTI due to ESBL-E. coli. Our aim was to evaluate the impact of the globally dominant sequence type (ST)131 clone and its clades, on the risk of subsequent recurrences with ESBL-E. coli. Isolates from patients developing RUTI (68/297) were compared with those from patients with sporadic UTI (SUTI, 229/297). No association was found between RUTI and the two most prevalent phylogroups B2 and D, blaCTX-M genes, or resistance profile. Half of the patients with RUTI were infected with ST131 isolates. Clade C2 were in dominance (50/119) among ST131 isolates. They were more common in patients with RUTI than SUTI (28% vs 13%) and multivariate analysis showed an increased odds-ratio (OR = 2.21, p = 0.033) for recurrences in patients infected with these isolates as compared to non-ST131 isolates. Detecting specific biomarkers, as ST131 clade C2, in ESBL-E. coli UTI isolates may aid in prediction of RUTI and improve diagnostics and care of patients with a risk of ESBL-E. coli recurrences.
摘要：
产超广谱β-内酰胺酶大肠杆菌(ESBL-E.大肠杆菌)，主要引起尿路感染（UTI），非常令人担忧。几乎三分之一的UTI患者，发展复发性UTI(RUTI)。我们对297名患者进行了为期一年的随访，因为他们的第一次UTI发作是由于ESBL-E。大肠杆菌。我们的目的是评估全球显性序列类型（ST）131克隆及其进化枝的影响，关于ESBL-E后续复发的风险大肠杆菌。从发生RUTI（68/297）的患者中分离出的菌株与散发性UTI（SUTI，229/297)。在RUTI和两个最普遍的系统群B2和D之间没有发现关联，blaCTX-M基因,或阻力剖面。一半的RUTI患者感染了ST131分离株。分化体C2在ST131分离株中占优势(50/119)。它们在RUTI患者中比SUTI更常见（28％vs13％），多变量分析显示，与非-相比，感染这些分离株的患者复发的比值比增加（OR=2.21，p=0.033）-ST131分离株。检测特定的生物标志物，作为ST131进化枝C2，在ESBL-E中大肠杆菌UTI分离株可能有助于RUTI的预测，并改善具有ESBL-E风险的患者的诊断和护理。大肠杆菌复发.
