PDF(Pubmed)
Abstract：
UNASSIGNED: Extraintestinal Escherichia coli infections represent a growing public health threat, However, current studies often overlook important factors such as temporal patterns of infection, phylogenetic and clonal background, or the host gut E. coli population, despite their likely significance.
UNASSIGNED: In this study, we analyzed >7000 clinical E. coli isolates from patients at the Minneapolis Veterans Affairs Health Care System (2012-2019), and concurrent fecal E. coli from uninfected veterans. We assessed phylogenetic group distribution, membership in selected sequence types (STs), and subsets thereof-including the pandemic, resistance-associated ST131-H30R, and ST1193 lineages-and strain type, as defined by pulsed-field gel electrophoresis. We then analyzed these features alongside the temporal patterns of infection in individual hosts.
UNASSIGNED: The H30R lineage emerged as the leading lineage, both overall and among fluoroquinolone-resistant isolates, with ST1193 following among fluoroquinolone-resistant isolates. Recurrences were common, occurring in 31% of subjects and 41% of episodes, and often multiple and delayed/prolonged (up to 23 episodes per subject; up to 2655d post-index). Remarkably, these recurrences typically involved the subject\'s index strain (63% of recurrences), even when affecting extra-urinary sites. ST131, H30R, ST1193, and fluoroquinolone-resistant strains generally caused significantly more recurrences than did other strains, despite similar recurrence intervals. ST131 strain types shifted significantly over the study period. Infection-causing strains were commonly detectable in host feces at times other than during an infection episode; the likelihood of detection varied with surveillance intensity and proximity to the infection. H30R and ST1193 were prominent causes of fecal-clinical clonal overlap.
UNASSIGNED: These findings provide novel insights into the temporal and clonal characteristics of E. coli infections in veterans and support efforts to develop anti-colonization interventions.
UNASSIGNED: In this study, we analyzed >7000 clinical E. coli isolates from patients at the Minneapolis Veterans Affairs Health Care System (2012-2019), and concurrent fecal E. coli from uninfected veterans. We assessed phylogenetic group distribution, membership in selected sequence types (STs), and subsets thereof-including the pandemic, resistance-associated ST131-H30R, and ST1193 lineages-and strain type, as defined by pulsed-field gel electrophoresis. We then analyzed these features alongside the temporal patterns of infection in individual hosts.
UNASSIGNED: The H30R lineage emerged as the leading lineage, both overall and among fluoroquinolone-resistant isolates, with ST1193 following among fluoroquinolone-resistant isolates. Recurrences were common, occurring in 31% of subjects and 41% of episodes, and often multiple and delayed/prolonged (up to 23 episodes per subject; up to 2655d post-index). Remarkably, these recurrences typically involved the subject\'s index strain (63% of recurrences), even when affecting extra-urinary sites. ST131, H30R, ST1193, and fluoroquinolone-resistant strains generally caused significantly more recurrences than did other strains, despite similar recurrence intervals. ST131 strain types shifted significantly over the study period. Infection-causing strains were commonly detectable in host feces at times other than during an infection episode; the likelihood of detection varied with surveillance intensity and proximity to the infection. H30R and ST1193 were prominent causes of fecal-clinical clonal overlap.
UNASSIGNED: These findings provide novel insights into the temporal and clonal characteristics of E. coli infections in veterans and support efforts to develop anti-colonization interventions.
摘要：
肠外大肠杆菌感染对公众健康的威胁越来越大，然而,目前的研究往往忽视了重要的因素，如感染的时间模式，系统发育和克隆背景，或宿主肠道大肠杆菌种群，尽管它们可能的意义。
■在这项研究中，我们分析了明尼阿波利斯退伍军人事务医疗保健系统（2012-2019）患者的7000种临床大肠杆菌分离株，和来自未感染退伍军人的粪便大肠杆菌。我们评估了系统发育组的分布，选定序列类型(ST)的成员资格，及其子集-包括大流行，电阻相关的ST131-H30R，和ST1193谱系-和菌株类型，如脉冲场凝胶电泳所定义。然后，我们分析了这些特征以及单个宿主中感染的时间模式。
■H30R谱系成为主要谱系，无论是整体还是氟喹诺酮耐药分离株，在氟喹诺酮耐药分离株中使用ST1193。反复发作很常见，发生在31%的受试者和41%的发作中，通常是多次和延迟/延长（每个受试者最多23次发作；索引后高达2655d）。值得注意的是,这些复发通常涉及受试者的指数应变(63%的复发)，即使影响尿外部位。ST131,H30R,ST1193和氟喹诺酮耐药菌株通常比其他菌株引起更多的复发，尽管复发间隔相似。ST131菌株类型在研究期间发生了显著变化。在感染发作期间以外的时间，通常可以在宿主粪便中检测到引起感染的菌株；检测的可能性随监测强度和与感染的接近程度而变化。H30R和ST1193是粪便-临床克隆重叠的主要原因。
■这些发现为退伍军人中大肠杆菌感染的时间和克隆特征提供了新的见解，并支持开发抗定植干预措施的努力。
■在这项研究中，我们分析了明尼阿波利斯退伍军人事务医疗保健系统（2012-2019）患者的7000种临床大肠杆菌分离株，和来自未感染退伍军人的粪便大肠杆菌。我们评估了系统发育组的分布，选定序列类型(ST)的成员资格，及其子集-包括大流行，电阻相关的ST131-H30R，和ST1193谱系-和菌株类型，如脉冲场凝胶电泳所定义。然后，我们分析了这些特征以及单个宿主中感染的时间模式。
■H30R谱系成为主要谱系，无论是整体还是氟喹诺酮耐药分离株，在氟喹诺酮耐药分离株中使用ST1193。反复发作很常见，发生在31%的受试者和41%的发作中，通常是多次和延迟/延长（每个受试者最多23次发作；索引后高达2655d）。值得注意的是,这些复发通常涉及受试者的指数应变(63%的复发)，即使影响尿外部位。ST131,H30R,ST1193和氟喹诺酮耐药菌株通常比其他菌株引起更多的复发，尽管复发间隔相似。ST131菌株类型在研究期间发生了显著变化。在感染发作期间以外的时间，通常可以在宿主粪便中检测到引起感染的菌株；检测的可能性随监测强度和与感染的接近程度而变化。H30R和ST1193是粪便-临床克隆重叠的主要原因。
■这些发现为退伍军人中大肠杆菌感染的时间和克隆特征提供了新的见解，并支持开发抗定植干预措施的努力。
