220928 Molecular Epidemiological Characterization of Uropathogenic Escherichia coli From An Outpatient Urology Clinic in Nagano, Japan

Monday, November 8, 2010 : 12:35 PM - 12:50 PM

Yasuyo Diana Umene, BA , UC Berkeley-UCSF Joint Medical Program, Berkeley, CA
Satowa Suzuki, MD, PhD , Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Tokyo, Japan
Tomoya Satoh, MD, PhD , Satoh Continence Clinic, Saku, Nagano, Japan
Kunikazu Yamane, MD, PhD , Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Tokyo, Japan
Lisa Wong, BA , School of Public Health, UC Berkeley, Berkeley, CA
Lee W. Riley, MD , School of Public Health, University of California-Berkeley, Division of Infectious Diseases and Epidemiology, Berkeley, CA
Yoshichika Arakawa, MD, PhD , Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Tokyo, Japan
An increasing prevalence of multidrug-resistant Escherichia coli causing extraintestinal infections is a growing public health concern. The prevalence in a hospital or community of drug-resistant urinary tract infection (UTI) is greatly affected by clonal composition of uropathogenic drug-resistant E. coli strains. We assessed the clonality and diversity of UTI-causing E. coli in one rural community in Japan. Patients presenting to a private urology clinic located in a rural community with UTI and no underlying medical conditions were recruited from Oct 2008 to Aug 2009. Participants provided a urine sample and completed a questionnaire regarding demographic and clinical information. Antibiotic susceptibility test and multilocus sequence typing of all E. coli isolates were performed. Of 136 patients with UTI, 81 (59.5%) were infected with E. coli; 5 had trimethoprim-sulfamethoxazole resistance (6.2%) and 4 had levofloxacin resistance (4.9%). 41 of the 81 isolates comprised 5 distinct clonal complexes (Cplx). ST95 Cplx accounted for 24.7% (n=20), ST131 Cplx for 8.6% (n=7), ST357 Cplx for 7.4% (n=6), ST73 Cplx for 6.2% (n=5), and ST69 Cplx for 3.7% (n=3) of all E. coli isolates. The high clonality among the isolated E. coli from epidemiologically unrelated patients in a community suggests a spread of certain strains by routes other than hospital-associated person-to-person transmission. Since ST95, ST131 and ST69 Cplx are well documented global epidemic multidrug-resistant or food animal related E. coli strains, our findings further support the notion that global food trade may be contributing to the spread of these strains.

Learning Areas:
Epidemiology
Public health or related research

Learning Objectives:
Describe the clonality of uropathogenic E. coli isolated from patients with unrelated epidemiological background in relation to the global spread of certain strains.

Keywords: Epidemiology, Genetics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a 2nd year medical student in the UCB-UCSF Joint Medical Program, I have taken courses on principles of infectious diseases, epidemiology, and biostatistics. I also spent 2 months during the summer of 2009 at the National Institute of Infectious Diseases, Japan as a research intern working under the supervision of a molecular epidemiologist.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.