title: Molecular epidemiology of extraintestinal pathogenic Escherichia coli isolates from a regional cohort of elderly patients highlights the prevalence of ST131 strains with increased antimicrobial resistance in both community and hospital care settings.
abstract: OBJECTIVE
  To assess the molecular epidemiology and prevalence of antibiotic resistance in Escherichia coli causing urinary tract infections of elderly patients from community and hospital settings. Also, to determine whether the possession of antibiotic resistance and virulence-associated genes can be linked to patient location or the clonal group of the organisms in question.
  
  
  METHODS
  E. coli were isolated from the urine samples of elderly patients from the Nottingham area, and subjected to antibiotic susceptibility testing, virulence gene detection by PCR and multilocus sequence typing.
  
  
  RESULTS
  No correlation was observed between community- or hospital-derived strains with regard to antibiotic resistance levels or virulence gene profiles. E. coli ST131 (where ST stands for sequence type) was the predominant ST found in both hospital and community samples, and demonstrated high levels of antibiotic resistance to the test panel, but did not possess a significantly larger array of virulence genes or a specific gene profile compared with other STs.
  
  
  CONCLUSIONS
  The level of antibiotic resistance or virulence gene possession in uropathogenic E. coli is not directly associated with the healthcare setting of the patient, but there is a variation in antibiotic resistance and virulence gene possession depending on clonal group. ST131 is highly virulent and demonstrates high levels of antibiotic resistance, but its virulence does not appear to be attributable to the possession of a specific virulence-associated gene set or the possession of any virulence-associated gene in significantly higher levels than in any other ST.
authors.affiliation: Pathogen Research Group, Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, UK.
authors.forename: Gemma
authors.initials: G
authors.lastname: Croxall
authors.forename: James
authors.initials: J
authors.lastname: Hale
authors.forename: Vivienne
authors.initials: V
authors.lastname: Weston
authors.forename: Georgina
authors.initials: G
authors.lastname: Manning
authors.forename: Phil
authors.initials: P
authors.lastname: Cheetham
authors.forename: Mark
authors.initials: M
authors.lastname: Achtman
authors.forename: Alan
authors.initials: A
authors.lastname: McNally
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques; D002460:Cell Line; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics* / Q000502:physiology*; D004926:Escherichia coli / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D029968:Escherichia coli Proteins / Q000235:genetics; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D037521:Virulence Factors / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D029968:Escherichia coli Proteins; D037521:Virulence Factors; C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases