title: Clonal distribution and associated characteristics of Escherichia coli clinical and surveillance isolates from a military medical center.
abstract: Antimicrobial-resistant Escherichia coli are a concern for military health services. We studied 100 extended-spectrum beta-lactamase (ESBL)-producing and non-producing E. coli clinical and surveillance isolates from military personnel and civilians at Brooke Army Medical Center (2007-2011). Major E. coli lineages, most prominently ST10 (24%), ST131 (16%), and ST648 (8%), were distributed much as reported for other North American populations. ST131, represented mainly by its resistance-associated ST131-H30 clonal subset, was uniquely associated with a clinical origin, regardless of ESBL status. Thus, clonal background predicted resistance phenotype and clinical versus surveillance origin, and these findings could assist military clinicians and epidemiologists.
authors.affiliation: University of British Columbia, School of Population and Public Health, Vancouver, BC, Canada. Electronic address: amee.manges@ubc.ca.
authors.forename: Amee R
authors.initials: AR
authors.lastname: Manges
authors.affiliation: Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; San Antonio Military Medical Center, JBSA Fort Sam Houston, TX, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA. Electronic address: katrin.mende.ctr@mail.mil.
authors.forename: Katrin
authors.initials: K
authors.lastname: Mende
authors.affiliation: San Antonio Military Medical Center, JBSA Fort Sam Houston, TX, USA. Electronic address: clinton.murray@us.army.mil.
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
authors.affiliation: Minneapolis Veterans Health Care System, Minneapolis, Minnesota, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA. Electronic address: bdj26miles@yahoo.com.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Johnston
authors.affiliation: Department of Microbiology, University of Washington, Seattle, WA, USA. Electronic address: evs@u.washington.edu.
authors.forename: Evgeni V
authors.initials: EV
authors.lastname: Sokurenko
authors.affiliation: Department of Microbiology, University of Washington, Seattle, WA, USA. Electronic address: veronika@uw.edu.
authors.forename: Veronika
authors.initials: V
authors.lastname: Tchesnokova
authors.affiliation: Minneapolis Veterans Health Care System, Minneapolis, Minnesota, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA. Electronic address: johns007@umn.edu.
authors.forename: James R
authors.initials: JR
authors.lastname: Johnson
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004352:Drug Resistance, Microbial / Q000187:drug effects; D004926:Escherichia coli / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology*; D006772:Hospitals, Military; D006801:Humans; D008889:Military Personnel; D017720:Molecular Epidemiology / Q000379:methods; D058885:Multilocus Sequence Typing / Q000379:methods; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases
keywords: Antimicrobial resistance; Escherichia coli infections; Extended-spectrum beta-lactamases; Military medicine; Molecular epidemiology; Multilocus sequence typing; ST131; ST131-H30; Veterans; Virulence genes