title: Global molecular epidemiology of the O15:K52:H1 extraintestinal pathogenic Escherichia coli clonal group: evidence of distribution beyond Europe.
abstract: Escherichia coli O15:K52:H1 is a significant extraintestinal pathogen in Europe (G. Prats et al., J. Clin. Microbiol. 38:201-209, 2000). To search for evidence of this clonal group outside of Europe, 75 non-European E. coli isolates of serogroup O15 were compared with five members of the O15:K52:H1 clonal group from Barcelona, Spain, according to genomic background, virulence genotypes, and antimicrobial resistance profiles. Amplification phylotyping showed that 16 (21%) of the 75 non-European O15 isolates corresponded with the O15:K52:H1 clonal group. The 16 non-European O15:K52:H1 clonal group members represented diverse geographic locales. They were isolated almost exclusively from humans with extraintestinal infections and accounted for 50% of all O15 isolates from five human clinical collections studied. Most non-European clonal group members exhibited a consensus virulence factor profile that included the F16 or F7-2 papA alleles (P fimbrial structural subunit), papG allele II (P fimbrial adhesin), iha (putative adhesin siderophore), and iutA (aerobactin receptor). This resembles the virulence profiles of (i) European representatives of the O15:K52:H1 clonal group and (ii) phylogenetically related "clonal group A," a recently recognized significant contributor to trimethoprim-sulfamethoxazole resistance in the United States (A. R. Manges et al., N. Engl. J. Med. 345:1007-1013, 2001). Antimicrobial resistance profiles were variable, and resistance was inconsistently transferred by conjugation. These findings indicate that the O15:K52:H1 clonal group is broadly distributed beyond Europe, exhibits previously unrecognized phenotypic and genotypic diversity, and contributes significantly to extraintestinal infections in humans.
authors.affiliation: Medical Service, Minneapolis VA Medical Center, MN 55417, USA. johns007@tc.umn.edu
authors.forename: James R
authors.initials: JR
authors.lastname: Johnson
authors.forename: Adam L
authors.initials: AL
authors.lastname: Stell
authors.forename: Timothy T
authors.initials: TT
authors.lastname: O'Bryan
authors.forename: Michael
authors.initials: M
authors.lastname: Kuskowski
authors.forename: Bogdan
authors.initials: B
authors.lastname: Nowicki
authors.forename: Candice
authors.initials: C
authors.lastname: Johnson
authors.forename: Joel N
authors.initials: JN
authors.lastname: Maslow
authors.forename: Anil
authors.initials: A
authors.lastname: Kaul
authors.forename: Justine
authors.initials: J
authors.lastname: Kavle
authors.forename: Guillem
authors.initials: G
authors.lastname: Prats
mesh_terms: D000818:Animals; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism; D002417:Cattle; D003227:Conjugation, Genetic; D004285:Dogs; D024881:Drug Resistance, Bacterial / Q000235:genetics; D004926:Escherichia coli / Q000145:classification* / Q000235:genetics* / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D005408:Flagellin / Q000235:genetics / Q000378:metabolism; D014943:Global Health; D006801:Humans; D017720:Molecular Epidemiology; D019081:O Antigens; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D011817:Rabbits; D012703:Serotyping; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology; D014774:Virulence / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D019081:O Antigens; D005408:Flagellin