title: Epidemiology and characteristics of Escherichia coli sequence type 131 (ST131) from long-term care facility residents colonized intestinally with fluoroquinolone-resistant Escherichia coli.
abstract: The objective of this study was to evaluate molecular and epidemiologic factors associated with Escherichia coli sequence type 131 (ST131) among long-term care facility (LTCF) residents who acquired gastrointestinal tract colonization with fluoroquinolone-resistant E. coli (FQREC). Colonizing isolates from 37 residents who newly developed FQREC colonization at three LTCFs from 2006 to 2008 were evaluated. Twenty-nine (78%) of 37 total FQREC colonizing isolates were ST131. Most ST131 isolates had a distinctive combination of gyrA and parC replacement mutations. The ST131 and non-ST131 isolates differed significantly for the prevalence of many individual virulence factors but not for the proportion that qualified molecularly as extraintestinal pathogenic E. coli (ExPEC) or aggregate virulence factor scores. E. coli ST131 was highly prevalent among LTCF residents with FQREC colonization. Future studies should determine the risk factors for infection among ST131-colonized residents, and assess the potential for increased transmissibility of ST131 in the long-term care setting.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA; Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA. Electronic address: jennifer.han@uphs.upenn.edu.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Han
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Charles
authors.initials: C
authors.lastname: Garrigan
authors.affiliation: Minneapolis Veterans Affairs Medical Center, Minneapolis, MN; Department of Medicine, University of Minnesota, Minneapolis, MN.
authors.forename: Brian
authors.initials: B
authors.lastname: Johnston
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Irving
authors.initials: I
authors.lastname: Nachamkin
authors.affiliation: Minneapolis Veterans Affairs Medical Center, Minneapolis, MN.
authors.forename: Connie
authors.initials: C
authors.lastname: Clabots
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA; Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA.
authors.forename: Warren B
authors.initials: WB
authors.lastname: Bilker
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Santana
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA.
authors.forename: Pam
authors.initials: P
authors.lastname: Tolomeo
authors.affiliation: GeneOne Life Science, Inc., Seoul, South Korea.
authors.forename: Joel
authors.initials: J
authors.lastname: Maslow
authors.affiliation: Coatesville Veterans Affairs Medical Center, Coatesville, PA.
authors.forename: Janice
authors.initials: J
authors.lastname: Myers
authors.affiliation: Division of Geriatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Lesley
authors.initials: L
authors.lastname: Carson
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA; Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA.
authors.forename: Ebbing
authors.initials: E
authors.lastname: Lautenbach
authors.affiliation: Minneapolis Veterans Affairs Medical Center, Minneapolis, MN; Department of Medicine, University of Minnesota, Minneapolis, MN.
authors.forename: James R
authors.initials: JR
authors.lastname: Johnson
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D058345:Asymptomatic Infections / Q000453:epidemiology*; D027081:DNA Gyrase / Q000235:genetics; D027101:DNA Topoisomerase IV / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology*; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008826:Microbial Sensitivity Tests; D037521:Virulence Factors / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D024841:Fluoroquinolones; D037521:Virulence Factors; D027101:DNA Topoisomerase IV; D027081:DNA Gyrase
keywords: Escherichia coli; Long-term care; ST131