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Antimicrobial Agents and Chemotherapy, July 2009, p. 2733-2739, Vol. 53, No. 7
0066-4804/09/$08.00+0     doi:10.1128/AAC.00297-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Epidemic Clonal Groups of Escherichia coli as a Cause of Antimicrobial-Resistant Urinary Tract Infections in Canada, 2002 to 2004{triangledown}

James R. Johnson,1,2* Megan Menard,1,2 Brian Johnston,1,2 Michael A. Kuskowski,1,3 Kim Nichol,4 and George G. Zhanel4,5,6

Veterans Affairs Medical Center, Minneapolis, Minnesota,1 Department of Medicine, University of Minnesota, Minneapolis, Minnesota,2 Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota,3 Department of Clinical Microbiology, Health Sciences Centre, Winnipeg, Manitoba, Canada,4 Department of Medical Microbiology, Faculty of Medicine, University of Manitoba, Manitoba, Canada,5 Department of Medicine, Health Sciences Centre, Winnipeg, Manitoba, Canada6

Received 4 March 2009/ Returned for modification 14 April 2009/ Accepted 16 April 2009

The extent to which clonal spread contributes to emerging antimicrobial resistance in Escherichia coli is incompletely defined. To address this question within a recent, nationally representative strain collection, three established drug-resistant E. coli clonal groups (i.e., clonal group A, E. coli O15:K52:H1, and sequence type 131 [ST131]) were sought among 199 E. coli urine isolates recovered from across Canada from 2002 to 2004, with stratification by resistance to trimethoprim-sulfamethoxazole (TS) and fluoroquinolones (FQs). The isolates' clonal backgrounds, virulence genotypes, and macrorestriction profiles were assessed. The three clonal groups were found to account for 37.2% of isolates overall, but accounted for 0% of TS-susceptible (TS-S) and FQ-susceptible (FQ-S) isolates, 20% of TS-resistant (TS-R) and FQ-S isolates, 60% of TS-S and FQ-R isolates, and 68% of TS-R and FQ-R isolates (P < 0.001). E. coli ST131, the most prevalent clonal group, accounted for 23.1% of isolates overall and for 44% of the FQ-R isolates. Nearly all ST131 isolates were FQ-R (96%) but, notably, cephalosporin susceptible (98%). Although the distinctive virulence profiles of the FQ-R clonal group isolates were less extensive than those of the susceptible isolates, they were significantly more extensive than those of the other FQ-R isolates. These findings indicate that among the E. coli urine isolates studied, resistance to TS and FQs has a prominent clonal component, with the O15:K52:H1 clonal group and especially E. coli ST131 being the major contributors. These clonal groups appear to be more virulent than comparably resistant isolates, possibly contributing to their success as emerging multi-drug-resistant pathogens.

* Corresponding author. Mailing address: Infectious Diseases (111F), Minneapolis VA Medical Center, 1 Veterans Drive, Minneapolis, MN 55417. Phone: (612) 467-4185. Fax: (612) 727-5995. E-mail: johns007{at}umn.edu

{triangledown} Published ahead of print on 27 April 2009.

Antimicrobial Agents and Chemotherapy, July 2009, p. 2733-2739, Vol. 53, No. 7
0066-4804/09/$08.00+0     doi:10.1128/AAC.00297-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Johnson, J. R., Miller, S., Johnston, B., Clabots, C., DebRoy, C. (2009). Sharing of Escherichia coli Sequence Type ST131 and Other Multidrug-Resistant and Urovirulent E. coli Strains among Dogs and Cats within a Household. J. Clin. Microbiol. 47: 3721-3725 [Abstract] [Full Text]  
  • Ender, P. T., Gajanana, D., Johnston, B., Clabots, C., Tamarkin, F. J., Johnson, J. R. (2009). Transmission of an Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli (Sequence Type ST131) Strain between a Father and Daughter Resulting in Septic Shock and Emphysematous Pyelonephritis. J. Clin. Microbiol. 47: 3780-3782 [Abstract] [Full Text]  


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