title: Globally dispersed mobile drug-resistance genes in gram-negative bacterial isolates from patients with bloodstream infections in a US urban general hospital.
abstract: Mobile drug-resistance genes with identical nucleic acid sequences carried by multidrug-resistant Escherichia coli strains that cause community-acquired infections are becomingly increasingly dispersed worldwide. Over a 2-year period, we analysed gram-negative bacterial (GNB) pathogens from the blood of inpatients at an urban public hospital to determine what proportion of these isolates carried such globally dispersed drug-resistance genes. Of 376 GNB isolates, 167 (44 %) were Escherichia coli, 50 (13 %) were Klebsiella pneumoniae, 25 (7 %) were Pseudomonas aeruginosa, 25 (7 %) were Proteus mirabilis and 20 (5 %) were Enterobacter cloacae; the remainder (24 %) comprised 26 different GNB species. Among E. coli isolates, class 1 integrons were detected in 64 (38 %). The most common integron gene cassette configuration was dfrA17-aadA5, found in 30 (25 %) of 119 drug-resistant E. coli isolates and in one isolate of Moraxella morganii. Extended-spectrum β-lactamase (ESBL) genes were found in 16 E. coli isolates (10 %). These genes with identical sequences were found in nearly 40 % of bloodstream E. coli isolates in the study hospital, as well as in a variety of bacterial species from clinical and non-clinical sources worldwide. Thus, a substantial proportion of bloodstream infections among hospitalized patients were caused by E. coli strains carrying drug-resistance genes that are dispersed globally in a wide variety of bacterial species.
authors.affiliation: School of Public Health, Division of Infectious Diseases and Vaccinology, University of California, Berkeley, CA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Adams-Sapper
authors.affiliation: School of Public Health, Division of Infectious Diseases and Vaccinology, University of California, Berkeley, CA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Sergeevna-Selezneva
authors.affiliation: School of Public Health, Division of Infectious Diseases and Vaccinology, University of California, Berkeley, CA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Tartof
authors.affiliation: School of Public Health, Division of Infectious Diseases and Vaccinology, University of California, Berkeley, CA, USA.
authors.forename: E
authors.initials: E
authors.lastname: Raphael
authors.affiliation: Department of Medicine, University of California, San Francisco, CA, USA.
authors.forename: B An
authors.initials: BA
authors.lastname: Diep
authors.affiliation: Department of Medicine, University of California, San Francisco, CA, USA.
authors.forename: F
authors.initials: F
authors.lastname: Perdreau-Remington
authors.affiliation: School of Public Health, Division of Infectious Diseases and Vaccinology, University of California, Berkeley, CA, USA.
authors.forename: L W
authors.initials: LW
authors.lastname: Riley
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology*; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D024881:Drug Resistance, Bacterial; D005798:Genes, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D006769:Hospitals, General; D006801:Humans; D020071:Interspersed Repetitive Sequences; D015995:Prevalence; D017422:Sequence Analysis, DNA; D014481:United States / Q000453:epidemiology; D014505:Urban Population
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial