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06 19, 2019;32 (3):

Global Extraintestinal Pathogenic Escherichia coli (ExPEC) Lineages.

Amee R Manges, Hyun Min Geum, Alice Guo, Thaddeus J Edens, Chad D Fibke, Johann D D Pitout
Author Information
  1. Amee R Manges: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada amee.manges@ubc.ca.
  2. Hyun Min Geum: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
  3. Alice Guo: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
  4. Thaddeus J Edens: Devil's Staircase Consulting, West Vancouver, British Columbia, Canada.
  5. Chad D Fibke: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
  6. Johann D D Pitout: Calgary Laboratory Services, Calgary, Alberta, Canada.
PMID: 31189557 DOI: 10.1128/CMR.00135-18

Abstract

Extraintestinal pathogenic (ExPEC) strains are responsible for a majority of human extraintestinal infections globally, resulting in enormous direct medical and social costs. ExPEC strains are comprised of many lineages, but only a subset is responsible for the vast majority of infections. Few systematic surveillance systems exist for ExPEC. To address this gap, we systematically reviewed and meta-analyzed 217 studies (1995 to 2018) that performed multilocus sequence typing or whole-genome sequencing to genotype recovered from extraintestinal infections or the gut. Twenty major ExPEC sequence types (STs) accounted for 85% of isolates from the included studies. ST131 was the most common ST from 2000 onwards, covering all geographic regions. Antimicrobial resistance-based isolate study inclusion criteria likely led to an overestimation and underestimation of some lineages. European and North American studies showed similar distributions of ExPEC STs, but Asian and African studies diverged. Epidemiology and population dynamics of ExPEC are complex; summary proportion for some STs varied over time (e.g., ST95), while other STs were constant (e.g., ST10). Persistence, adaptation, and predominance in the intestinal reservoir may drive ExPEC success. Systematic, unbiased tracking of predominant ExPEC lineages will direct research toward better treatment and prevention strategies for extraintestinal infections.

Keywords

Escherichia coli extraintestinal infections extraintestinal pathogenic E. coli molecular epidemiology

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MeSH Term

Drug Resistance, Bacterial
Escherichia coli Infections
Extraintestinal Pathogenic Escherichia coli
Genome, Bacterial
Humans
Journal Article Meta-Analysis Systematic Review
Article has an altmetric score of 14

Word Cloud

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