Escherichia coli of human and avian origin: detection of clonal groups associated with fluoroquinolone and multidrug resistance in Italy

• Published in: Journal of antimicrobial chemotherapy Vol. 67; no. 4; pp. 860 - 867
• Main Authors: Giufrè, Maria, Graziani, Caterina, Accogli, Marisa, Luzzi, Ida, Busani, Luca, Cerquetti, Marina
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-04-2012; Oxford Publishing Limited (England)
• Subjects: Adolescent; Animals; Anti-Bacterial Agents - pharmacology; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial diseases; Bacterial diseases of the urinary system; Biological and medical sciences; Chickens; Child; Child, Preschool; Ciprofloxacin; Cloning; Cluster Analysis; Drug resistance; Drug Resistance, Multiple; Drug Resistance, Multiple, Bacterial; E coli; Escherichia coli; Escherichia coli - drug effects; Escherichia coli - isolation & purification; Escherichia coli Infections - microbiology; Escherichia coli Infections - veterinary; Female; Fluoroquinolones; Fluoroquinolones - pharmacology; Genotype; Genotypes; Human bacterial diseases; Humans; Infant; Infection; Infectious diseases; Italy; Male; Medical sciences; Multidrug resistance; Multilocus Sequence Typing; Nephrology. Urinary tract diseases; Pharmacology. Drug treatments; Phylogenetics; Phylogeny; Poultry; Poultry Diseases - microbiology; Sepsis; Sepsis - microbiology; Turkeys; Urinary system involvement in other diseases. Miscellaneous; Urinary tract; Urinary Tract Infections - microbiology; Urinary tract. Prostate gland; Italy; Europe; molecular epidemiology; MLST; zoonosis; urinary tract infections; Human origin; Treatment resistance; Urinary system disease; Escherichia coli; Bird; Genotype; Urinary tract disease; Zoonosis; Infection; Vertebrata; Fluoroquinolone derivatives; Urinary tract infection; Multiple resistance; Molecular epidemiology; Bacteria; Diagnosis; Antibacterial agent; Aves; Detection; Enterobacteriaceae
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkr565

Objectives
Poultry have been suggested as a reservoir for fluoroquinolone-resistant extraintestinal pathogenic Escherichia coli (ExPEC). Our aim was to investigate whether genotypes associated with ciprofloxacin and multidrug resistance were shared among human and avian E. coli.
Methods
We compared 277 human ExPEC isolates from urinary tract infection (UTI) and sepsis (142 susceptible and 135 ciprofloxacin resistant) and 101 avian isolates (68 susceptible and 33 ciprofloxacin resistant) by antimicrobial resistance phenotype, phylogenetic group and multilocus sequence type (ST).
Results
Most ciprofloxacin-resistant isolates from both human and avian sources were multidrug resistant. Human and avian isolates strongly differed in phylogenetic group assignment (B2 and A predominated among human and avian isolates, respectively), but a shift towards group A associated with ciprofloxacin resistance was observed among human isolates (8/100, 8.0% versus 17/87, 19.5%, P = 0.021 for UTI and 5/42, 11.9% versus 15/48, 31.3%, P = 0.028 for sepsis). Heterogeneity of ST clones was observed, with ST131 strongly predominant in human ciprofloxacin-resistant strains (58/135, 43.0%), but not in avian strains. However, two major ST clonal complexes (CCs; CC10 and CC23, both belonging to group A) associated with ciprofloxacin resistance and multiresistance were shared by human and avian isolates.
Conclusions
The major human and avian E. coli ST clones associated with multidrug resistance were identified. A subset of ST clones belonging to CC10 and CC23 poses a potential zoonotic risk.