Trends of extended-spectrum β-lactamase-producing Escherichia coli sequence type 131 and its H30 subclone in a French hospital over a 15-year period.
Sequence type 131 (ST131) is a predominant lineage among extraintestinal pathogenic Escherichia coli. It plays a major role in the worldwide dissemination of E. coli producing extended-spectrum β-lactamases (ESBLs). Here we describe the long-term epidemiology of this clonal group in a French university hospital, where the incidence of ESBL-producing E. coli has increased from 0.018 case per 1000 patient-days in the year 2000 to 0.50 case per 1000 patient-days in 2014. The first of the 141 ST131 isolates was recovered in 2006, and the ST131 clonal group accounted for 18.1% of total ESBL-producing E. coli over the whole period (2000-2014). Subclonal typing showed that 75.9% (107/141) of ST131 isolates were H30, of which 81.3% (87/107) were H30-Rx. The large majority (137/141) of ESBLs produced were of the CTX-M group, with 94 CTX-M-15, 19 CTX-M-1, 10 CTX-M-27, 8 CTX-M-14 and four other CTX-M types (n = 6). Pulsed-field gel electrophoresis (PFGE) analysis showed high diversity, which increased during the course of the study. The 141 ST131 isolates clustered in 53 pulsotypes (PTs), with 2 dominant PTs (PT14 and PT13) with 36 and 17 isolates, respectively. These findings showed that ST131 was a predominant clone among ESBL-producing E. coli in our hospital, even though it only accounted for <20%. Moreover, ST131 should be regarded not as a unified entity but as a cluster of distinct clonal subsets even if the increase in resistance within ST131 has a strong clonal basis, being attributable mainly to the spread of C1/H30-R and C2/H30-Rx clades.
Service d'hygiène hospitalière, Centre Hospitalier Régional Universitaire, Besançon, France; UMR 6249 Laboratoire Chrono-environnement, Université de Bourgogne-Franche-Comté, Besançon, France; Centre de ressources biologiques Ferdinand Cabanne, Centre Hospitalier Régional Universitaire, Besançon, France.
Marlène
M
Sauget
Service d'hygiène hospitalière, Centre Hospitalier Régional Universitaire, Besançon, France; UMR 6249 Laboratoire Chrono-environnement, Université de Bourgogne-Franche-Comté, Besançon, France.
Pascal
P
Cholley
Service d'hygiène hospitalière, Centre Hospitalier Régional Universitaire, Besançon, France.
Andréa
A
Vannier
Service d'hygiène hospitalière, Centre Hospitalier Régional Universitaire, Besançon, France; UMR 6249 Laboratoire Chrono-environnement, Université de Bourgogne-Franche-Comté, Besançon, France.
Michelle
M
Thouverez
Service de microbiologie, Hôpital Beaujon AP-HP, Clichy, France; Faculté de médecine D. Diderot, INSERM UMR 1149, Université Paris 7, Paris, France.
Marie-Hélène
MH
Nicolas-Chanoine
Service d'hygiène hospitalière, Centre Hospitalier Régional Universitaire, Besançon, France; UMR 6249 Laboratoire Chrono-environnement, Université de Bourgogne-Franche-Comté, Besançon, France; Centre de ressources biologiques Ferdinand Cabanne, Centre Hospitalier Régional Universitaire, Besançon, France.
Didier
D
Hocquet
Service d'hygiène hospitalière, Centre Hospitalier Régional Universitaire, Besançon, France; UMR 6249 Laboratoire Chrono-environnement, Université de Bourgogne-Franche-Comté, Besançon, France. Electronic address: xbertrand@chu-besancon.fr.
Xavier
X
Bertrand
D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000145:classification* / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D005602:France / Q000453:epidemiology; D014644:Genetic Variation; D005838:Genotype; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D012189:Retrospective Studies; D001618:beta-Lactamases / Q000378:metabolism*
D001618:beta-Lactamases
ESBL; Extended-spectrum β-lactamase; Multidrug resistance; PFGE