Extended-spectrum β-lactamase-producing Escherichia coli in human-derived and foodchain-derived samples from England, Wales, and Scotland: an epidemiological surveillance and typing study - 28/11/19
Summary |
Background |
Extended-spectrum β-lactamase-producing Escherichia coli isolates (ESBL-E coli) cause more than 5000 cases of bacteraemias annually in the UK. The contribution of the food chain to these infections is debated. We aimed to identify the most important reservoirs of ESBL-E coli that colonise and infect humans to identify strategic intervention points.
Methods |
Sampling for ESBL-E coli was done between Aug 1, 2013, and Dec 15, 2014. We used selective media to seek ESBL-E coli in routinely submitted samples from human faeces, and prospectively collected samples from sewage, farm slurry, and retail foodstuffs in London, East Anglia, northwest England, Scotland, and Wales. We sequenced recovered isolates and compared these isolates with 293 bloodstream and 83 veterinary surveillance ESBL-E coli isolates from the same regions.
Findings |
2157 (11%) of 20 243 human faeces samples contained ESBL-E coli, including 678 (17%) of 3995 in London. ESBL-E coli also were frequent in sewage and retail chicken (104 [65%] of 159 meat samples), but were rare in other meats and absent from plant-based foods (0 of 400 fruit and vegetable samples). Sequence type (ST) 131 dominated among ESBL-E coli from human blood (188 [64%] of 293 isolates), faeces (128 [36%] of 360), and sewage (14 [22%] of 65) with STs 38 and 648 also widespread; CTX-M-15 was the predominant ESBL in these lineages (319 [77%] of 416). By contrast, STs 602, 23, and 117—mostly with CTX-M-1 ESBL—dominated among food and veterinary isolates (68 [31%] of 218), with only two ST131 organisms recovered. ST10 occurred in both animals and humans, being frequent in surveillance bovines (11 [22%] of 51 cattle) and representing 15 (4%) of 360 human faecal isolates (but only three [1%] of 293 from bacteraemias); however, both human and animal ST10 isolates were diverse in serotype.
Interpretation |
Most human bacteraemias with ESBL-E coli in the UK involve internationally prevalent human-associated STs, particularly ST131; non-human reservoirs made little contribution to invasive human disease. Any interventions that seek to target food or livestock can affect the numbers of human infections caused by ESBL-E coli; prevention of the spread of resistant lineages among humans is more vital.
Funding |
NIHR Policy Research.
Le texte complet de cet article est disponible en PDF.Plan
Vol 19 - N° 12
P. 1325-1335 - décembre 2019 Retour au numéro
Article précédent
- The global burden of non-typhoidal salmonella invasive disease: a systematic analysis for the Global Burden of Disease Study 2017
- GBD 2017 Non-Typhoidal Salmonella Invasive Disease Collaborators, Jeffrey D. Stanaway, Andrea Parisi, Kaushik Sarkar, Brigette F. Blacker, Robert C Reiner, Simon I. Hay, Molly R Nixon, Christiane Dolecek, Spencer L. James, Ali H Mokdad, Getaneh Abebe, Elham Ahmadian, Fares Alahdab, Birhan Tamene T Alemnew, Vahid Alipour, Fatemeh Allah Bakeshei, Megbaru Debalkie Animut, Fereshteh Ansari, Jalal Arabloo, Ephrem Tsegay Asfaw, Mojtaba Bagherzadeh, Quique Bassat, Yaschilal Muche Muche Belayneh, Félix Carvalho, Ahmad Daryani, Feleke Mekonnen Demeke, Asmamaw Bizuneh Bizuneh Demis, Manisha Dubey, Eyasu Ejeta Duken, Susanna J Dunachie, Aziz Eftekhari, Eduarda Fernandes, Reza Fouladi Fard, Getnet Azeze Gedefaw, Birhanu Geta, Katherine B Gibney, Amir Hasanzadeh, Chi Linh Hoang, Amir Kasaeian, Amir Khater, Zelalem Teklemariam Kidanemariam, Ayenew Molla Lakew, Reza Malekzadeh, Addisu Melese, Desalegn Tadese Mengistu, Tomislav Mestrovic, Bartosz Miazgowski, Karzan Abdulmuhsin Mohammad, Mahdi Mohammadian, Abdollah Mohammadian-Hafshejani, Cuong Tat Nguyen, Long Hoang Nguyen, Son Hoang Nguyen, Yirga Legesse Nirayo, Andrew T Olagunju, Tinuke O Olagunju, Hadi Pourjafar, Mostafa Qorbani, Mohammad Rabiee, Navid Rabiee, Anwar Rafay, Aziz Rezapour, Abdallah M. Samy, Sadaf G. Sepanlou, Masood Ali Shaikh, Mehdi Sharif, Mika Shigematsu, Belay Tessema, Bach Xuan Tran, Irfan Ullah, Ebrahim M Yimer, Zoubida Zaidi, Christopher J L Murray, John A Crump
- Effect of infectious disease consultation on mortality and treatment of patients with candida bloodstream infections: a retrospective, cohort study
- Carlos Mejia-Chew, Jane A O’Halloran, Margaret A Olsen, Dustin Stwalley, Ryan Kronen, Charlotte Lin, Ana S Salazar, Lindsey Larson, Kevin Hsueh, William G Powderly, Andrej Spec
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?