Tanaka Mayuko, Hanawa Tomoko, Suda Tomoya, Tanji Yasunori, Minh Le Nhat, Kondo Kohei, Azam Aa Haeruman, Kiga Kotaro, Yonetani Shota, Yashiro Ryu, Ohmori Takuya, Matsuda Takeaki
Department of General Medicine, Kyorin University School of Medicine, Tokyo, Japan.
Department of Traumatology and Critical Care Medicine, Kyorin University School of Medicine, Tokyo, Japan.
Front Microbiol. 2025 Apr 24;16:1571121. doi: 10.3389/fmicb.2025.1571121. eCollection 2025.
The prevalence of extended-spectrum β-lactamase (ESBL)-producing () is a global health concern due to the multidrug antimicrobial resistance in extraintestinal pathogenic (ExPEC). ExPEC causes severe infections such as bloodstream infections, meningitis, and sepsis. Uropathogenic (UPEC), a subset of ExPEC, is responsible for urinary tract infections (UTIs), ranging from asymptomatic bacteriuria and cystitis to more severe conditions, such as pyelonephritis, bacteremia, and sepsis (urosepsis). Although ESBL-producing may have a significant impact on patient outcomes, comparisons of genotype and virulence factors between ESBL-producing and non-ESBL-producing have not fully elucidated the factors influencing its pathogenicity. Therefore, in the present study, we analyzed the genotypes and virulence-associated genes of ESBL-producing strains isolated from the blood of patients with UTIs to determine the characteristics of ESBL-producing UPEC strains associated with severe infections. Most of the clinical isolates belonged to phylogroup B2, with the exception of three strains from phylogroup D. The MLST was ST131, followed by ST73, ST95, and ST38, which are commonly found in UPEC strains. Intriguingly, ST131 strains were associated with fewer sepsis cases compared to non-ST131 strains (8 of 38 cases by ST131 and 5 of 8 cases by non-ST131 [OR, 0.16; 95% CI, 0.038-0.873; = 0.031]). analysis of 23 clinical isolates revealed that the genes detected in all strains may play a significant role in the pathogenesis of invasive UTIs. Clustering and gene locus analysis highlighted the genotype-MLST dependence of UPEC-specific virulence-associated genes. ST38-specific strains were atypical, characterized by the absence of several UPEC-specific genes, including loci, pathogenicity island marker (), and , as well as the presence of genes encoding Ycb fimbriae and a Type 3 secretion system, which are typically found in enteropathogenic (EPEC). These results suggest that the virulence of clinical isolates causing invasive infections can vary, and that the pathogenicity of UPEC should be considered when analyzing the correlation between MLST and the repertoire of virulence-associated genes.
产超广谱β-内酰胺酶(ESBL)的[具体细菌名称未给出]由于肠外致病性[具体细菌名称未给出](ExPEC)中的多药抗菌耐药性而成为全球健康关注的问题。ExPEC会引发严重感染,如血流感染、脑膜炎和败血症。尿路致病性[具体细菌名称未给出](UPEC)是ExPEC的一个子集,可导致尿路感染(UTIs),范围从无症状菌尿症和膀胱炎到更严重的病症,如肾盂肾炎、菌血症和败血症(尿脓毒症)。尽管产ESBL的[具体细菌名称未给出]可能对患者预后有重大影响,但产ESBL和不产ESBL的[具体细菌名称未给出]之间基因型和毒力因子的比较尚未完全阐明影响其致病性的因素。因此,在本研究中,我们分析了从UTIs患者血液中分离出的产ESBL菌株的基因型和毒力相关基因,以确定与严重感染相关的产ESBL UPEC菌株的特征。除了3株来自D菌群的菌株外,大多数临床分离株属于B2菌群。多位点序列分型(MLST)为ST131,其次是ST73、ST95和ST38,这些在UPEC菌株中很常见。有趣的是,与非ST131菌株相比,ST131菌株的败血症病例较少(ST131菌株38例中有8例,非ST131菌株8例中有5例[比值比,0.16;95%可信区间,0.038 - 0.873;P = 0.031])。对23株临床分离株的分析表明,在所有菌株中检测到的基因可能在侵袭性UTIs的发病机制中起重要作用。聚类和基因座分析突出了UPEC特异性毒力相关基因对基因型-MLST的依赖性。ST38特异性菌株是非典型的,其特征是缺乏几个UPEC特异性基因,包括[具体基因名称未给出]位点、致病岛标记([具体标记名称未给出])和[具体基因名称未给出],以及存在编码Ycb菌毛和III型分泌系统的基因,这些通常在肠致病性[具体细菌名称未给出](EPEC)中发现。这些结果表明,引起侵袭性感染的临床分离株的毒力可能不同,并且在分析MLST与毒力相关基因库之间的相关性时应考虑UPEC的致病性。