Evaluation of MLVA for Epidemiological Typing and Outbreak Detection of ESBL-producing Escherichia Coli in Sweden

Overview

Journal BMC Microbiol

Publisher Biomed Central

Specialty Microbiology

Date 2017 Jan 8

PMID 28061803

Citations 10

Authors

Lisa Helldal

Nahid Karami

Christina Welinder-Olsson

Edward R B Moore

Christina Ahren

Affiliations

Soon will be listed here.

Abstract

Background: To identify the spread of nosocomial infections and halt outbreak development caused by Escherichia coli that carry multiple antibiotic resistance factors, such as extended-spectrum beta-lactamases (ESBLs) and carbapenemases, is becoming demanding challenges due to the rapid global increase and constant and increasing influx of these bacteria from the community to the hospital setting. Our aim was to assess a reliable and rapid typing protocol for ESBL-E. coli, with the primary focus to screen for possible clonal relatedness between isolates. All clinical ESBL-E. coli isolates, collected from hospitals (n = 63) and the community (n = 41), within a single geographical region over a 6 months period, were included, as well as clinical isolates from a polyclonal outbreak (ST131, n = 9, and ST1444, n = 3). The sporadic cases represented 36 STs, of which eight STs dominated i.e. ST131 (n = 33 isolates), ST648 (n = 10), ST38 (n = 9), ST12 and 69 (each n = 4), ST 167, 405 and 372 (each n = 3). The efficacy of multiple-locus variable number tandem repeat analysis (MLVA) was evaluated using three, seven or ten loci, in comparison with that of pulsed-field gel electrophoresis (PFGE) and multi locus sequence typing (MLST).

Results: MLVA detected 39, 55 and 60 distinct types, respectively, using three (GECM-3), seven (GECM-7) or ten (GECM-10) loci. For GECM-7 and -10, 26 STs included one type and eleven STs each included several types, the corresponding numbers for GECM-3 were 29 and 8. The highest numbers were seen for ST131 (7,7 and 8 types, respectively), ST38 (5,5,8) and ST648 (4,5,5). Good concordance was observed with PFGE and GECM-7 and -10, despite fewer types being identified with MLVA; 78 as compared to 55 and 60 types. The lower discriminatory power of MLVA was primarily seen within the O25b-ST131 lineage (n = 34) and its H30-Rx subclone (n = 21). Epidemiologically unrelated O25b-ST131 isolates were clustered with O25b-ST131 outbreak isolates by MLVA, whereas the ST1444 outbreak isolates were accurately distinguished from unrelated isolates.

Conclusion: MLVA, even when using only three loci, represents an easy initial typing tool for epidemiological screening of ESBL-E. coli. For the ST131-O25b linage, complementary methods may be needed to obtain sufficient resolution.

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References

Ny S, Lofmark S, Borjesson S, Englund S, Ringman M, Bergstrom J . Community carriage of ESBL-producing Escherichia coli is associated with strains of low pathogenicity: a Swedish nationwide study. J Antimicrob Chemother. 2016; 72(2):582-588. DOI: 10.1093/jac/dkw419. View

Brink A, von Wintersdorff C, van der Donk C, Peeters A, Beisser P, Stobberingh E . Development and validation of a single-tube multiple-locus variable number tandem repeat analysis for Klebsiella pneumoniae. PLoS One. 2014; 9(3):e91209. PMC: 3948817. DOI: 10.1371/journal.pone.0091209. View

Kjerulf A, Hansen D, Sandvang D, Hansen F, Frimodt-Moller N . The prevalence of ESBL-producing E. coli and Klebsiella strains in the Copenhagen area of Denmark. APMIS. 2008; 116(2):118-24. DOI: 10.1111/j.1600-0463.2008.00777.x. View

Christiansson M, Melin S, Matussek A, Lofgren S, Soderman J . MLVA is a valuable tool in epidemiological investigations of Escherichia coli and for disclosing multiple carriage. Scand J Infect Dis. 2011; 43(8):579-86. DOI: 10.3109/00365548.2011.568953. View

Manges A, Tellis P, Vincent C, Lifeso K, Geneau G, Reid-Smith R . Multi-locus variable number tandem repeat analysis for Escherichia coli causing extraintestinal infections. J Microbiol Methods. 2009; 79(2):211-3. DOI: 10.1016/j.mimet.2009.09.006. View

Drieux L, Brossier F, Sougakoff W, Jarlier V . Phenotypic detection of extended-spectrum beta-lactamase production in Enterobacteriaceae: review and bench guide. Clin Microbiol Infect. 2007; 14 Suppl 1:90-103. DOI: 10.1111/j.1469-0691.2007.01846.x. View

Rogers B, Sidjabat H, Paterson D . Escherichia coli O25b-ST131: a pandemic, multiresistant, community-associated strain. J Antimicrob Chemother. 2010; 66(1):1-14. DOI: 10.1093/jac/dkq415. View

Welinder-Olsson C, Kjellin E, Badenfors M, Kaijser B . Improved microbiological techniques using the polymerase chain reaction and pulsed-field gel electrophoresis for diagnosis and follow-up of enterohaemorrhagic Escherichia coli infection. Eur J Clin Microbiol Infect Dis. 2001; 19(11):843-51. DOI: 10.1007/s100960000380. View

van Belkum A, Tassios P, Dijkshoorn L, Haeggman S, Cookson B, Fry N . Guidelines for the validation and application of typing methods for use in bacterial epidemiology. Clin Microbiol Infect. 2007; 13 Suppl 3:1-46. DOI: 10.1111/j.1469-0691.2007.01786.x. View

10.

Brolund A, Haeggman S, Edquist P, Gezelius L, Olsson-Liljequist B, Tegmark Wisell K . The DiversiLab system versus pulsed-field gel electrophoresis: characterisation of extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae. J Microbiol Methods. 2010; 83(2):224-30. DOI: 10.1016/j.mimet.2010.09.004. View

11.

Colpan A, Johnston B, Porter S, Clabots C, Anway R, Thao L . Escherichia coli sequence type 131 (ST131) subclone H30 as an emergent multidrug-resistant pathogen among US veterans. Clin Infect Dis. 2013; 57(9):1256-65. PMC: 3792724. DOI: 10.1093/cid/cit503. View

12.

Nielsen J, Albayati A, Jorgensen R, Hansen K, Lundgren B, Schonning K . An abbreviated MLVA identifies Escherichia coli ST131 as the major extended-spectrum β-lactamase-producing lineage in the Copenhagen area. Eur J Clin Microbiol Infect Dis. 2012; 32(3):431-6. DOI: 10.1007/s10096-012-1764-x. View

13.

Nicolas-Chanoine M, Bertrand X, Madec J . Escherichia coli ST131, an intriguing clonal group. Clin Microbiol Rev. 2014; 27(3):543-74. PMC: 4135899. DOI: 10.1128/CMR.00125-13. View

14.

Matsumura Y, Yamamoto M, Nagao M, Tanaka M, Takakura S, Ichiyama S . Detection of Escherichia coli sequence type 131 clonal group among extended-spectrum β-lactamase-producing E. coli using VITEK MS Plus matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Microbiol Methods. 2015; 119:7-9. DOI: 10.1016/j.mimet.2015.09.016. View

15.

Naseer U, Natas O, Haldorsen B, Bue B, Grundt H, Walsh T . Nosocomial outbreak of CTX-M-15-producing E. coli in Norway. APMIS. 2007; 115(2):120-6. DOI: 10.1111/j.1600-0463.2007.apm_547.x. View

16.

Goering R . Pulsed field gel electrophoresis: a review of application and interpretation in the molecular epidemiology of infectious disease. Infect Genet Evol. 2010; 10(7):866-75. DOI: 10.1016/j.meegid.2010.07.023. View

17.

Muller V, Karami N, Nyberg L, Pichler C, Torche Pedreschi P, Quaderi S . Rapid Tracing of Resistance Plasmids in a Nosocomial Outbreak Using Optical DNA Mapping. ACS Infect Dis. 2016; 2(5):322-8. DOI: 10.1021/acsinfecdis.6b00017. View

18.

Hu Y, Li B, Jin D, He L, Tao X, Zhang J . Identification of Variable-Number Tandem-Repeat (VNTR) Sequences in Acinetobacter pittii and Development of an Optimized Multiple-Locus VNTR Analysis Typing Scheme. Biomed Environ Sci. 2016; 28(12):855-63. DOI: 10.3967/bes2015.119. View

19.

Price L, Johnson J, Aziz M, Clabots C, Johnston B, Tchesnokova V . The epidemic of extended-spectrum-β-lactamase-producing Escherichia coli ST131 is driven by a single highly pathogenic subclone, H30-Rx. mBio. 2013; 4(6):e00377-13. PMC: 3870262. DOI: 10.1128/mBio.00377-13. View

20.

Pitout J, Campbell L, Church D, Wang P, Guttman D, Gregson D . Using a commercial DiversiLab semiautomated repetitive sequence-based PCR typing technique for identification of Escherichia coli clone ST131 producing CTX-M-15. J Clin Microbiol. 2009; 47(4):1212-5. PMC: 2668328. DOI: 10.1128/JCM.02265-08. View