Endemic and Epidemic Lineages of<i>Escherichia coli</i>that Cause Urinary Tract Infections
Notice bibliographique
Résumé
Women with urinary tract infections (UTIs) in California, USA (1999)(2000)(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 profi le, enterobacterial repetitive intergenic consensus 2 PCR, serotyping, XbaI and NotI pulsed-fi eld gel electrophoresis, multilocus sequence typing, and phylogenetic typing.We confi rmed 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 identifi ed in both locations.Epidemic transmission followed by endemic transmission of UTI-causing clonal groups may explain these clusters of UTI cases. C ommunity-acquired extraintestinal infections withEs- cherichia coli range in frequency from 6 to 8 million cases of uncomplicated cystitis per year to 127,500 cases of sepsis per year in the United States (1).Urinary tract infections (UTIs) caused by E. coli are one of the most common extraintestinal infections in women and, because of their high incidence, are the focus of most epidemiologic studies.The source of E. coli for these infections is a person's intestinal tract; however, how these E. coli are acquired by the gut is unclear.Risk factors that lead to intestinal colo-nization with extraintestinal E. coli differ from factors associated with development of infection.Young, otherwise healthy, sexually active women have the highest risk for community-acquired UTIs.The main risk factors for UTI are recent and frequent sexual intercourse, contraceptive use, and a history of UTIs (2,3).Treatment for UTIs usually involves a short course of an antimicrobial drug, such as trimethoprim-sulfamethoxazole (TMP-SMZ).Over the past decade, the prevalence of drug resistance in E. coli has increased dramatically, complicating management of these infections.Across the United States and Canada, urinary tract isolates of E. coli from outpatient clinics showed increased resistance to TMP-SMZ and ampicillin (4).A more serious concern has been the gradual increase in fl uoroquinolone (e.g., ciprofl oxacin) resistance among UTI isolates (5).There is increasing evidence that the E. coli that cause UTIs and other extraintestinal infections may be responsible for community-wide epidemics.In 1986-1987, E. coli O15:K52:H1 caused an outbreak of community-acquired UTIs and septicemia in South London, England (6).The distinctive drug resistance profi le of this clonal group contributed to its recognition in London and other areas of Europe and the United States (7,8).Other outbreaks of UTI caused by E. coli have been described and include a cluster of UTI cases in Copenhagen, Denmark, caused by E. coli O78:H10 and a larger outbreak in Calgary, Alberta, Canada, caused by extended-spectrum β-lactamase (ESBL)producing E. coli (9,10).In 2001, we reported that a multidrug-resistant E. coli clonal group designated clonal group A (CgA), defi ned by an enterobacterial repetitive intergenic consensus 2 (ERIC2) PCR and characterized by O11, O77, O17, and O73:K52:H18 serotypes, caused 11% of all E. coli UTIs and 49% of all TMP-SMZ-resistant E. coli UTIs in 1 Endemic and Epidemic Lineages of Escherichia coli that Cause Urinary Tract Infections
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».