Within-household transmission of extraintestinal pathogenic Escherichia coli (ExPEC) may contribute to the pathogenesis of urinary tract infection (UTI), but this is poorly understood.
A woman with acute UTI, 4 human household members who cohabited with her, and the family's pet dog underwent prospective longitudinal surveillance for colonizing E. coli for 7-9 weeks after the woman's UTI episode. Unique clones were resolved by random amplified polymorphic DNA and pulsed-field gel electrophoresis analysis. Virulence genes, phylogenetic group, and O types were defined by PCR. Comparisons with reference strains were made using random amplified polymorphic DNA profiling.
Serial fecal and urine samples from the 6 household members yielded 7 unique E. coli clones (4 of which were ExPEC and 3 of which were non-ExPEC). For 3 clones, extensive among-host sharing was evident in patterns suggesting host-to-host transmission. The mother's UTI clone, which represented E. coli O1:K1:H7, was the clone that was most extensively shared (in 5 hosts, including the dog) and most frequently recovered (in 45% of samples and at all 3 time points). The other 3 ExPEC clones corresponded with E. coli O6:K2:H1, O1:K1:H7, and O2:F10,F48.
E. coli clones, including ExPEC, can be extensively shared among human and animal household members in the absence of sexual contact and in patterns suggesting host-to-host transmission.
"Inappropriate empirical treatment and wide spread use of antimicrobials in these animals leads to antimicrobial resistance which complicates therapy in dogs. Public health significance of these infections cannot be overlooked as cats and dogs being companion animals remain in close physical contact with human beings in modern society and represent potential sources of spread of antimicrobial resistance to human beings (Low et al., 1988; Kurazono et al., 2003; Guardabassi et al., 2004; Johnson and Clabots, 2006). "
[Show abstract][Hide abstract] ABSTRACT: Study was carried out on 96 swabs of uterine discharge of bitches with a history of infertility and repeat breeding irrespective of their age or breed, received in College Central Laboratory. On bacteriological examination, 92 (95.83%) were found positive for bacterial growth yielding 120 isolates. Of these positive samples, 65 (70.65%) yielded single bacterial species, 26 (28.26%) yielded two species, and the remaining 1 (1.08%) yielded 3 different bacterial species. Of 120 isolates, Streptococcus pyogenes was the predominant organism accounting for 55 (45.83%) infections followed by Staphylococcus aureus 23 (19.16%), Escherichia coli 20 (16.66%), Corynebacterium pyogenes 19 (15.83%), Pseudomonas aeruginosa 2 (1.67%) and Klebseilla pneumoniae 1(0.83%). Most common mixed infection was of S. aureus + S. pyogenes (11) and S. pyogenes + C. pyogenes (7) followed by other combinations S. pyogenes + E. coli (3), C. pyogenes+ E. coli (2), S. aureus + S. pyogenes + C. pyogenes (1), P. aeruginosa + S. pyogenes (1), E. coli + K. pneumoniae (1), S. aureus + C. pyogenes (1). Overall antimicrobial sensitivity pattern revealed that majority of the isolates were highly sensitive (80.20 to 89.58%) for azithromycin, norfloxacin, ceftriaxone, cephaperazone and clindamycin. Whereas 77.08 to 79.16% bacterial isolates were moderately sensitive
towards oxytetracycline, chloramphenicol, ciprofloxacin, erythromycin, gentamicin, amoxycillin, carbenicillin. Least sensitivity (44.79 to 72.91%) towards isolates were shown by penicillin, streptomycin, ampicillin, neomycin, cloxacillin, enrofloxacin, amoxyclav, co-trimaxole, cephalexin. Therefore, for rational use of antibiotics, prior testing of antibiotic sensitivity is suggested.
"In an infection control study, clonal expansion of two genetically distinct clonal groups of MDREC was evident, the hospital environment was readily contaminated and rectal carriage was demonstrated in both hospitalised dogs and veterinary hospital employees . These findings have public health implications, as canine ExPEC strains share pathotypic and phylogenetic similarities with ExPEC strains isolated from humans and between-host-species transmission has previously been demonstrated  . "
[Show abstract][Hide abstract] ABSTRACT: The study established the virulence potential of multidrug-resistant Escherichia coli (MDREC) isolates from nosocomial infections in hospitalised dogs. The isolates were resistant to fluoroquinolones, belonged to two distinct clonal groups (CG1 and CG2) and contained a plasmid-mediated AmpC (CMY-7) beta-lactamase. CG1 isolates (n=14) possessed two of 36 assayed extraintestinal virulence genes (iutA and traT) and belonged to phylogenetic group A, whereas CG2 isolates (n=19) contained four such genes (iutA, ibeA, fimH and kpsMT K5) and belonged to group D. In a mouse gastrointestinal tract colonisation model, colonisation by index CG1 strain C1 was transient, in contrast to the index CG2 strain C2b, which persisted up to 40days post-inoculation. In a mouse subcutaneous challenge model, both strains were less virulent than archetypal group B2 extraintestinal pathogenic E. coli (ExPEC) strain CFT073; strain C1 caused no systemic signs and strain C2b was lethal to only one of six mice. In a mouse urinary tract infection model, strain C2b colonised the mouse bladder over 2 logs higher compared to strain C1. Whilst both groups of canine MDREC appear less virulent than a reference human ExPEC strain, CG2 strains have greater capacity for colonisation and virulence.
Microbes and Infection 12/2008; 11(1):100-7. DOI:10.1016/j.micinf.2008.10.014 · 2.86 Impact Factor
"Catheter-associated urinary tract infection (CAUTI), that is, UTI related to use of an indwelling urinary catheter, is the most common type of nosocomial infection in the United States and the most common source of gramnegative septicemia in hospitals . It affects primarily hospitalized patients but can occur in any catheterized individual, including community dwellers and long-term care facility residents. "
[Show abstract][Hide abstract] ABSTRACT: Urinary tract infection (UTI), with its diverse clinical syndromes and affected host groups, remains one of the most common but widely misunderstood and challenging infectious diseases encountered in clinical practice. Antimicrobial resistance is a leading concern, with few oral options available to treat infections caused by Gram-negative organisms resistant to trimethoprim-sulfamethoxazole and fluoroquinolones, especially for patients with upper tract disease. Efforts should be made not to detect or treat asymptomatic bacteriuria and funguria; to ensure an appropriate duration of therapy for symptomatic infections; and to limit the use of broad-spectrum agents, especially fluoroquinolones, if narrower spectrum agents are available. Further research is needed regarding rapid diagnosis of UTI, accurate presumptive identification of patients with resistant pathogens, and development of new antimicrobials for drug-resistant UTI.
Primary Care Clinics in Office Practice 07/2008; 35(2):345-67, vii. DOI:10.1016/j.pop.2008.01.001 · 0.74 Impact Factor
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