Diversity and trends in population structure of ESBL-producing Enterobacteriaceae in febrile urinary tract infections in children in France from 2014 to 2017.


Journal

The Journal of antimicrobial chemotherapy
ISSN: 1460-2091
Titre abrégé: J Antimicrob Chemother
Pays: England
ID NLM: 7513617

Informations de publication

Date de publication:
01 01 2020
Historique:
received: 29 06 2019
revised: 21 08 2019
accepted: 10 09 2019
pubmed: 17 10 2019
medline: 17 4 2021
entrez: 17 10 2019
Statut: ppublish

Résumé

The population structure of extraintestinal pathogenic Escherichia coli evolves over time, notably due to the emergence of antibiotic-resistant clones such as ESBL-producing Enterobacteriaceae (ESBL-E). To analyse by WGS the genetic diversity of a large number of ESBL-E isolated from urinary tract infections in children from paediatric centres across France between 2014 and 2017 and collected by the National Observatory of febrile urinary tract infection (FUTI) caused by ESBL-E. A total of 40 905 Enterobacteriaceae-positive urine cultures were identified. ESBL-E were found in 1983 samples (4.85%). WGS was performed on 251 ESBL-E causing FUTI. STs, core genome MLST (cgMLST), serotype, fimH allele, ESBL genes and presence of papGII key virulence factor were determined. E. coli and Klebsiella pneumoniae were found in 86.9% (218/251) and 11.2% (28/251) of cases, respectively. Several STs predominate among E. coli such as ST131, ST38, ST69, ST73, ST95, ST405, ST12 and ST1193, while no ST emerged in K. pneumoniae. E. coli ST131, ST38 and ST1193 increased during the study period, with a heterogeneity in papGII prevalence (64.5%, 35% and 20% respectively). Most isolates harboured the CTX-M type (97%) with a predominance of blaCTX-M-15. blaCTX-M-27, an emerging variant in E. coli, is found in various STs. cgMLST enabled discrimination of clusters within the main STs. The predominance of ST131, and the emergence of other STs such as ST38 and ST1193 combined with ESBL genes deserves close epidemiological surveillance considering their high threat in infectious disease. cgMLST could be a discriminant complementary tool for the analyses.

Sections du résumé

BACKGROUND
The population structure of extraintestinal pathogenic Escherichia coli evolves over time, notably due to the emergence of antibiotic-resistant clones such as ESBL-producing Enterobacteriaceae (ESBL-E).
OBJECTIVES
To analyse by WGS the genetic diversity of a large number of ESBL-E isolated from urinary tract infections in children from paediatric centres across France between 2014 and 2017 and collected by the National Observatory of febrile urinary tract infection (FUTI) caused by ESBL-E.
METHODS
A total of 40 905 Enterobacteriaceae-positive urine cultures were identified. ESBL-E were found in 1983 samples (4.85%). WGS was performed on 251 ESBL-E causing FUTI. STs, core genome MLST (cgMLST), serotype, fimH allele, ESBL genes and presence of papGII key virulence factor were determined.
RESULTS
E. coli and Klebsiella pneumoniae were found in 86.9% (218/251) and 11.2% (28/251) of cases, respectively. Several STs predominate among E. coli such as ST131, ST38, ST69, ST73, ST95, ST405, ST12 and ST1193, while no ST emerged in K. pneumoniae. E. coli ST131, ST38 and ST1193 increased during the study period, with a heterogeneity in papGII prevalence (64.5%, 35% and 20% respectively). Most isolates harboured the CTX-M type (97%) with a predominance of blaCTX-M-15. blaCTX-M-27, an emerging variant in E. coli, is found in various STs. cgMLST enabled discrimination of clusters within the main STs.
CONCLUSIONS
The predominance of ST131, and the emergence of other STs such as ST38 and ST1193 combined with ESBL genes deserves close epidemiological surveillance considering their high threat in infectious disease. cgMLST could be a discriminant complementary tool for the analyses.

Identifiants

pubmed: 31617912
pii: 5588579
doi: 10.1093/jac/dkz423
doi:

Substances chimiques

Anti-Bacterial Agents 0
Virulence Factors 0

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

96-105

Investigateurs

Marie-Noëlle Adam (MN)
Marlène Amara (M)
Isabelle Andriantahina (I)
Abdelmalek Belgaid (A)
Sandra Biscardi (S)
Sophie Boyer (S)
Catherine Branger (C)
Isabelle Breant (I)
Jack Breuil (J)
Jocelyne Caillon (J)
Emmanuel Cixous (E)
Bogdan Cojocaru (B)
Irina Craiu (I)
Marion Decobert (M)
Rodrigue Dessein (R)
Florence Doucet-Populaire (F)
François Dubos (F)
Sarah Ducrocq (S)
Anne Farges-Berth (A)
Cécile Farrugia (C)
Alain Fiacre (A)
Aurélien Galerne (A)
Hélène Garrec (H)
Emilie Georget (E)
Emmanuel Grimpel (E)
Laure Hees (L)
Franck Labbee (F)
Aurélia Pitsch (A)
Isabelle Poilane (I)
Valérie Sivadon-Tardy (V)
Valérie Soussan-Banini (V)
Benoit Starck (B)
Sandra Timsit (S)
Philippe Traore (P)
Anne Vachee (A)
Olivier Vignaud (O)

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

André Birgy (A)

Université de Paris, IAME, INSERM, F-75018, Paris, France.
AP-HP, Hôpital Robert Debré, Service de Microbiologie, F-75019, Paris, France.

Fouad Madhi (F)

Service de Pédiatrie Générale, Centre Hospitalier Intercommunal de Créteil, France.
Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.
Centre de Recherche Clinique, Centre Hospitalier Intercommunal de Créteil, France.

Camille Jung (C)

Service de Pédiatrie Générale, Centre Hospitalier Intercommunal de Créteil, France.
Centre de Recherche Clinique, Centre Hospitalier Intercommunal de Créteil, France.

Corinne Levy (C)

Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.
Association Clinique Thérapeutique Infantile du Val de Marne (ACTIV), Saint Maur des Fossés, France.
Université Paris Est, IMRB-GRC GEMINI, ACTIV, 94000, Créteil, France.

Aurélie Cointe (A)

Université de Paris, IAME, INSERM, F-75018, Paris, France.
AP-HP, Hôpital Robert Debré, Service de Microbiologie, F-75019, Paris, France.

Philippe Bidet (P)

Université de Paris, IAME, INSERM, F-75018, Paris, France.
AP-HP, Hôpital Robert Debré, Service de Microbiologie, F-75019, Paris, France.

Claire Amaris Hobson (CA)

Université de Paris, IAME, INSERM, F-75018, Paris, France.

Stéphane Bechet (S)

Association Clinique Thérapeutique Infantile du Val de Marne (ACTIV), Saint Maur des Fossés, France.

Elsa Sobral (E)

Association Clinique Thérapeutique Infantile du Val de Marne (ACTIV), Saint Maur des Fossés, France.

Hoang Vuthien (H)

AP-HP, HU-Est Parisien site Trousseau, Service de Bactériologie, F-75012, Paris, France.

Agnès Ferroni (A)

AP-HP, Hopital Necker, Service de Microbiologie, University Paris Descartes, Paris, France.

Saïd Aberrane (S)

Microbiology Laboratory, Créteil Hospital, Créteil, France.

Gaëlle Cuzon (G)

Bacteriology-Hygiene Unit, Assistance Publique/Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France.
Université Paris Sud, LabEx LERMIT, Faculty of Medicine, Le Kremlin-Bicêtre, France.
Associated French National Reference Center for Antibiotic Resistance: Carbapenemase-producing Enterobacteriaceae, Le Kremlin-Bicêtre, France.
Evolution and Ecology of Resistance to Antibiotics Unit, Institut Pasteur, APHP-Université Paris Sud, Paris, France.

Laetitia Beraud (L)

Centre National de Référence des Légionelles, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France.

Vincent Gajdos (V)

Service de Pédiatrie, Antoine Béclère University Hospital, Assistance Publique-Hôpitaux de Paris, Clamart, France.
Centre for Research in Epidemiology and Population Health, Villejuif, France.

Elise Launay (E)

Service de Pédiatrie Générale et Infectiologie Pédiatrique, Hôpital Femme-Enfant-Adolescent, Centre Hospitalier Universitaire de Nantes, Nantes, France.

Didier Pinquier (D)

Unité de Pneumologie et Allergologie pédiatriques & CRCM mixte, Pédiatrie Médicale, CHU Charles Nicolle, Rouen, France.

Hervé Haas (H)

Hôpitaux pédiatriques CHU Lenval, Nice, France.

Marie Desmarest (M)

Service d'Accueil des Urgences Pédiatriques, AP-HP, Hôpital Robert Debré, Paris, France.

Marie-Aliette Dommergues (MA)

Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.
Service de pédiatrie, centre hospitalier de Versailles, Le Chesnay, France.

Robert Cohen (R)

Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.
Centre de Recherche Clinique, Centre Hospitalier Intercommunal de Créteil, France.
Association Clinique Thérapeutique Infantile du Val de Marne (ACTIV), Saint Maur des Fossés, France.
Université Paris Est, IMRB-GRC GEMINI, ACTIV, 94000, Créteil, France.
Unité Court Séjour, Petits Nourrisson, Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, France.

Stéphane Bonacorsi (S)

Université de Paris, IAME, INSERM, F-75018, Paris, France.
AP-HP, Hôpital Robert Debré, Service de Microbiologie, F-75019, Paris, France.

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