title: Different factors associated with CTX-M-producing ST131 and non-ST131 Escherichia coli clinical isolates.
abstract: OBJECTIVE
  To determine factors associated with CTX-M-producing ST131 Escherichia coli which is the worldwide predominant lineage among CTX-M-producing E. coli isolates.
  
  
  METHODS
  Consecutive inpatients with a clinical sample positive for CTX-M-producing E. coli and considered as cases in a previous 8-month (2008-2009) case-control study performed in ten university hospitals in the Paris area were included in the present sub-population study. Patients with a CTX-M-producing ST131 E. coli clinical isolate were compared with those with a CTX-M-producing non-ST131 E. coli clinical isolate with regard to 66 variables. Variables were first compared using univariate logistic regression, then a multivariate analysis using a backward selection with variables with p-value <0.1 in univariate analysis was carried out.
  
  
  RESULTS
  Fifty-five patients with a CTX-M-producing ST131 E. coli clinical isolate were compared to 97 patients with a CTX-producing non-ST131 E. coli clinical isolate. Multivariate analysis showed that only previous residence in long term care facilities (OR=4.4; 95% CI=1.3-14.7) was positively associated with a CTX-M-producing ST131 E. coli isolate. However, it also showed that regular consumption of poultry products (OR=0.2; 95% CI=0.1-0.6), having had at least one device in the preceding 6 months (OR=0.3; 95% CI=0.1-0.7) and stay in ICU (OR=0.2; 95% CI=0.05-0.8) were negatively associated with isolation of CTX-M-producing ST131 E. coli from clinical samples.
  
  
  CONCLUSIONS
  This study provides more insight into the epidemiological features of ST131 and non-ST131 E. coli producing CTX-M enzymes. It shows, for the first time, that isolation of CTX-M-producing ST131 E. coli from clinical samples is not linked to consumption of various foods and confirms that residence in long term care facilities is a predictor of these isolates.
authors.affiliation: Service de Microbiologie, Hôpital Beaujon AP-HP, Clichy, France ; Faculté de Médecine D. Diderot, Paris, France ; Institut National de la Santé et de la Recherche Médicale, U773, Centre de Recherche Biomédicale Bichat-Beaujon (CRB3), Université Paris Diderot, Paris, France.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Nicolas-Chanoine
authors.forename: Jérôme
authors.initials: J
authors.lastname: Robert
authors.forename: Marie
authors.initials: M
authors.lastname: Vigan
authors.forename: Cédric
authors.initials: C
authors.lastname: Laouénan
authors.forename: Sylvain
authors.initials: S
authors.lastname: Brisse
authors.forename: France
authors.initials: F
authors.lastname: Mentré
authors.forename: Vincent
authors.initials: V
authors.lastname: Jarlier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004926:Escherichia coli / Q000201:enzymology* / Q000472:pathogenicity*; D004927:Escherichia coli Infections / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D055815:Young Adult; D001618:beta-Lactamases
chemical_list: D001618:beta-Lactamases
references.citation: Vet Microbiol. 2012 May 4;156(3-4):347-52
references.pmid: 22112854
references.citation: Emerg Infect Dis. 2010 Jan;16(1):88-95
references.pmid: 20031048
references.citation: J Antimicrob Chemother. 2013 Mar;68(3):562-8
references.pmid: 23143897
references.citation: J Antimicrob Chemother. 2010 Dec;65(12):2534-7
references.pmid: 20889530
references.citation: Int J Food Microbiol. 2012 Mar 15;154(3):212-4
references.pmid: 22260927
references.citation: Emerg Infect Dis. 2004 Sep;10(9):1697-8
references.pmid: 15503413
references.citation: Appl Environ Microbiol. 2010 May;76(9):2799-805
references.pmid: 20228098
references.citation: J Clin Microbiol. 2012 Sep;50(9):2974-81
references.pmid: 22760036
references.citation: Appl Environ Microbiol. 2010 Nov;76(21):6991-7
references.pmid: 20817805
references.citation: Clin Infect Dis. 2013 Feb;56(4):478-87
references.pmid: 23243181
references.citation: Antimicrob Agents Chemother. 2009 Jul;53(7):2733-9
references.pmid: 19398649
references.citation: Infect Immun. 2012 Apr;80(4):1554-62
references.pmid: 22311928
references.citation: PLoS One. 2012;7(12):e53039
references.pmid: 23300857
references.citation: Clin Infect Dis. 2012 Sep;55(5):712-9
references.pmid: 22615330
references.citation: Antimicrob Agents Chemother. 2004 Oct;48(10):3736-42
references.pmid: 15388428
references.citation: J Travel Med. 2011 Sep-Oct;18(5):299-303
references.pmid: 21896092
references.citation: PLoS One. 2012;7(9):e46547
references.pmid: 23029548
references.citation: J Antimicrob Chemother. 2009 Sep;64(3):635-41
references.pmid: 19549667
references.citation: J Antimicrob Chemother. 2011 Jan;66(1):1-14
references.pmid: 21081548
references.citation: J Antimicrob Chemother. 2012 Feb;67(2):346-56
references.pmid: 22028202
references.citation: Emerg Infect Dis. 2011 Jul;17(7):1216-22
references.pmid: 21762575
references.citation: PLoS One. 2012;7(1):e30498
references.pmid: 22299043
references.citation: Int J Food Microbiol. 2012 Oct 1;159(2):69-73
references.pmid: 23072690
references.citation: PLoS One. 2012;7(3):e34294
references.pmid: 22457832
references.citation: Infect Control Hosp Epidemiol. 2013 Apr;34(4):361-9
references.pmid: 23466908