title: Occurrence of antibiotic-resistant uropathogenic Escherichia coli clonal group A in wastewater effluents.
abstract: Isolates of Escherichia coli belonging to clonal group A (CGA), a recently described disseminated cause of drug-resistant urinary tract infections in humans, were present in four of seven sewage effluents collected from geographically dispersed areas of the United States. All 15 CGA isolates (1% of the 1,484 isolates analyzed) exhibited resistance to trimethoprim-sulfamethoxazole (TMP-SMZ), accounting for 19.5% of the 77 TMP-SMZ-resistant isolates. Antimicrobial resistance patterns, virulence traits, O:H serotypes, and phylogenetic groupings were compared for CGA and selected non-CGA isolates. The CGA isolates exhibited a wider diversity of resistance profiles and somatic antigens than that found in most previous characterizations of this clonal group. This is the first report of recovery from outside a human host of E. coli CGA isolates with virulence factor and antibiotic resistance profiles typical of CGA isolates from a human source. The occurrence of "human-type" CGA in wastewater effluents demonstrates a potential mode for the dissemination of this clonal group in the environment, with possible secondary transmission to new human or animal hosts.
authors.affiliation: US Environmental Protection Agency, Cincinnati, OH, USA.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Boczek
authors.forename: Eugene W
authors.initials: EW
authors.lastname: Rice
authors.forename: Brian
authors.initials: B
authors.lastname: Johnston
authors.forename: James R
authors.initials: JR
authors.lastname: Johnson
mesh_terms: D015373:Bacterial Typing Techniques; D001483:Base Sequence; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification; D024881:Drug Resistance, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000209:etiology / Q000382:microbiology; D029968:Escherichia coli Proteins / Q000235:genetics; D036781:Fimbriae Proteins / Q000235:genetics; D005798:Genes, Bacterial; D006801:Humans; D010802:Phylogeny; D019105:Random Amplified Polymorphic DNA Technique; D012722:Sewage / Q000382:microbiology*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology; D014552:Urinary Tract Infections / Q000209:etiology / Q000382:microbiology; D014774:Virulence / Q000235:genetics
chemical_list: C078802:AtpA protein, E coli; D004269:DNA, Bacterial; D029968:Escherichia coli Proteins; D012722:Sewage; D036781:Fimbriae Proteins; D015662:Trimethoprim, Sulfamethoxazole Drug Combination