Nüesch-Inderbinen Magdalena T, Baschera Melinda, Zurfluh Katrin, Hächler Herbert, Nüesch Hansjakob, Stephan Roger
National Centre for Enteropathogenic Bacteria and Listeria, Institute for Food Safety and Hygiene, University of Zurich, Zurich, Switzerland.
Practice for General and Internal Medicine, Seuzach, Switzerland.
Front Microbiol. 2017 Dec 1;8:2334. doi: 10.3389/fmicb.2017.02334. eCollection 2017.
The aim of this study was to assess the clonal structure, virulence potential and antibiotic susceptibility of uropathogenic (UPEC) isolates causing community acquired urinary tract infection (CAUTI) in unselected primary care patients in Switzerland. We performed multilocus sequence typing, virulence factor determination, and phenotypic and genotypic antimicrobial resistance testing on 44 non-duplicate UPEC isolates. Twenty-seven different sequence types (STs) were identified. Major UPEC clones were represented by 19 (43.2%) of the isolates, including ST131, ST69 (both 13.6%), ST73 (6.8%), ST10 (4.5%), ST127, ST140, (both 2.3%). Five (11.4%) isolates belonged to ST141. Aggregate virulence factor (VF) scores were highest among isolates belonging to ST127 and ST141. Overall, 50% of the isolates were susceptible to all 12 antimicrobials tested, and all isolates remained susceptible to fosfomycin and nitrofurantoin. Resistance to sulfamethoxazole and ciprofloxacin were found in 31.8, and 15.9% of the isolates, respectively. Plasmid-mediated resistance genes were detected in ST69 and ST131 and included ' (2.3% of all isolates) and (9%), and (13.6%). None of the isolates tested positive for or . Our results show that CAUTI in Switzerland is caused by a wide variety of UPEC STs for which fosfomycin remains a good treatment option. We suggest that ST141 is an emerging clone associated with UTI in the community, and warrants closer attention. Moreover, the high rate of harboring from patients without a history of antimicrobial therapy or hospitalization indicates that UPEC is an important reservoir for .
本研究的目的是评估在瑞士未经挑选的初级护理患者中引起社区获得性尿路感染（CAUTI）的尿路致病性大肠埃希菌（UPEC）分离株的克隆结构、毒力潜力和抗生素敏感性。我们对44株非重复的UPEC分离株进行了多位点序列分型、毒力因子测定以及表型和基因型抗菌药物耐药性检测。鉴定出27种不同的序列类型（STs）。主要的UPEC克隆由19株（43.2%）分离株代表，包括ST131、ST69（均为13.6%）、ST73（6.8%）、ST10（4.5%）、ST127、ST140（均为2.3%）。5株（11.4%）分离株属于ST141。在属于ST127和ST141的分离株中，聚集毒力因子（VF）得分最高。总体而言，50%的分离株对所有12种测试抗菌药物敏感，并且所有分离株对磷霉素和呋喃妥因仍敏感。分别在31.8%和15.9%的分离株中发现对磺胺甲恶唑和环丙沙星耐药。在ST69和ST131中检测到质粒介导的耐药基因，包括blaCTX-M-1（占所有分离株的2.3%）、blaTEM-1B（9%）和blaSHV-12（13.6%）。没有分离株对blaOXA-48或blaNDM-1检测呈阳性。我们的结果表明，瑞士的CAUTI由多种UPEC STs引起，磷霉素仍然是一种良好的治疗选择。我们认为ST141是社区中与UTI相关的新兴克隆，值得密切关注。此外，在没有抗菌治疗或住院史的患者中携带blaCTX-M-1的高比例表明UPEC是blaCTX-M-1的重要储存库。
