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Endemic and epidemic lineages of Escherichia coli that cause urinary tract infections.

Manges AR, Tabor H, Tellis P, Vincent C, Tellier PP - Emerging Infect. Dis. (2008)

Bottom Line: We compared strains of UTI-causing E. coli in California with strains causing such infections in Montréal, Québec, Canada.Two clonal groups were identified in both locations.Epidemic transmission followed by endemic transmission of UTI-causing clonal groups may explain these clusters of UTI cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada. amee.manges@mcgill.ca

ABSTRACT
Women with urinary tract infections (UTIs) in California, USA (1999-2001), were infected with closely related or indistinguishable strains of Escherichia coli (clonal groups), which suggests point source dissemination. We compared strains of UTI-causing E. coli in California with strains causing such infections in Montréal, Québec, Canada. Urine specimens from women with community-acquired UTIs in Montréal (2006) were cultured for E. coli. Isolates that caused 256 consecutive episodes of UTI were characterized by antimicrobial drug susceptibility profile, enterobacterial repetitive intergenic consensus 2 PCR, serotyping, XbaI and NotI pulsed-field gel electrophoresis, multilocus sequence typing, and phylogenetic typing. We confirmed the presence of drug-resistant, genetically related, and temporally clustered E. coli clonal groups that caused community-acquired UTIs in unrelated women in 2 locations and 2 different times. Two clonal groups were identified in both locations. Epidemic transmission followed by endemic transmission of UTI-causing clonal groups may explain these clusters of UTI cases.

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Temporal patterns of cases of urinary tract infections (UTIs) with Escherichia coli clonal groups by week in Montréal, Québec, Canada, 2006 (A), and Berkeley, California, USA, 1999–2001 (B). Clonal groups are identified by letters in boxes. Lines indicate the total number of UTIs with E. coli in each week for each study site. Samples were not analyzed during February–October 2000 in Berkeley.
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Figure 5: Temporal patterns of cases of urinary tract infections (UTIs) with Escherichia coli clonal groups by week in Montréal, Québec, Canada, 2006 (A), and Berkeley, California, USA, 1999–2001 (B). Clonal groups are identified by letters in boxes. Lines indicate the total number of UTIs with E. coli in each week for each study site. Samples were not analyzed during February–October 2000 in Berkeley.

Mentions: In considering the hypothesis of endemic versus epidemic transmission of these clonal groups, temporal clustering is a useful factor. Figure 5 shows the temporal pattern by week of UTI cases for all clonal groups in Montréal (Figure 5, panel A) and in California (Figure 5, panel B). Fluctuation in the number of E. coli UTIs over time corresponds closely to observation of clonal group–associated UTI cases. These results show clustering of some clonal groups, e.g., 3 of the 5 UTIs caused by CgH occurred in Montréal during week 7, and CgH did not appear again in Montréal after week 11. In California, CgA was present more frequently between October 1999 and February 2000 and dropped by 39% between the 2 sampling periods (14). CgB and CgD occurred exclusively in the second phase of the California study (Figure 5, panel B). Other clonal groups appeared throughout the year, although they often clustered by week. CgC was present during both data collection periods in California and caused UTIs throughout 2006 in Montréal. No clonal group members were identified during the summer in Montréal. However, this period corresponded to a decrease in the number of UTI cases at the student health services because of lower summer university enrollment (see total E. coli UTI by week, Figure 5).


Endemic and epidemic lineages of Escherichia coli that cause urinary tract infections.

Manges AR, Tabor H, Tellis P, Vincent C, Tellier PP - Emerging Infect. Dis. (2008)

Temporal patterns of cases of urinary tract infections (UTIs) with Escherichia coli clonal groups by week in Montréal, Québec, Canada, 2006 (A), and Berkeley, California, USA, 1999–2001 (B). Clonal groups are identified by letters in boxes. Lines indicate the total number of UTIs with E. coli in each week for each study site. Samples were not analyzed during February–October 2000 in Berkeley.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2609861&req=5

Figure 5: Temporal patterns of cases of urinary tract infections (UTIs) with Escherichia coli clonal groups by week in Montréal, Québec, Canada, 2006 (A), and Berkeley, California, USA, 1999–2001 (B). Clonal groups are identified by letters in boxes. Lines indicate the total number of UTIs with E. coli in each week for each study site. Samples were not analyzed during February–October 2000 in Berkeley.
Mentions: In considering the hypothesis of endemic versus epidemic transmission of these clonal groups, temporal clustering is a useful factor. Figure 5 shows the temporal pattern by week of UTI cases for all clonal groups in Montréal (Figure 5, panel A) and in California (Figure 5, panel B). Fluctuation in the number of E. coli UTIs over time corresponds closely to observation of clonal group–associated UTI cases. These results show clustering of some clonal groups, e.g., 3 of the 5 UTIs caused by CgH occurred in Montréal during week 7, and CgH did not appear again in Montréal after week 11. In California, CgA was present more frequently between October 1999 and February 2000 and dropped by 39% between the 2 sampling periods (14). CgB and CgD occurred exclusively in the second phase of the California study (Figure 5, panel B). Other clonal groups appeared throughout the year, although they often clustered by week. CgC was present during both data collection periods in California and caused UTIs throughout 2006 in Montréal. No clonal group members were identified during the summer in Montréal. However, this period corresponded to a decrease in the number of UTI cases at the student health services because of lower summer university enrollment (see total E. coli UTI by week, Figure 5).

Bottom Line: We compared strains of UTI-causing E. coli in California with strains causing such infections in Montréal, Québec, Canada.Two clonal groups were identified in both locations.Epidemic transmission followed by endemic transmission of UTI-causing clonal groups may explain these clusters of UTI cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada. amee.manges@mcgill.ca

ABSTRACT
Women with urinary tract infections (UTIs) in California, USA (1999-2001), were infected with closely related or indistinguishable strains of Escherichia coli (clonal groups), which suggests point source dissemination. We compared strains of UTI-causing E. coli in California with strains causing such infections in Montréal, Québec, Canada. Urine specimens from women with community-acquired UTIs in Montréal (2006) were cultured for E. coli. Isolates that caused 256 consecutive episodes of UTI were characterized by antimicrobial drug susceptibility profile, enterobacterial repetitive intergenic consensus 2 PCR, serotyping, XbaI and NotI pulsed-field gel electrophoresis, multilocus sequence typing, and phylogenetic typing. We confirmed the presence of drug-resistant, genetically related, and temporally clustered E. coli clonal groups that caused community-acquired UTIs in unrelated women in 2 locations and 2 different times. Two clonal groups were identified in both locations. Epidemic transmission followed by endemic transmission of UTI-causing clonal groups may explain these clusters of UTI cases.

Show MeSH
Related in: MedlinePlus