The role of epidemic resistance plasmids and international high-risk clones in the spread of multidrug-resistant Enterobacteriaceae
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Date
Authors
Mathers, Amy J.
Peirano, Gisele
Pitout, Johann D.D.
Journal Title
Journal ISSN
Volume Title
Publisher
American Society for Microbiology
Abstract
Escherichia coli ST131and Klebsiella pneumoniae ST258 emerged in the 2000s as important
human pathogens; have spread extensively throughout the world and are responsible for the rapid
increase in antimicrobial resistance among E. coli and K. pneumoniae respectively. E. coli
ST131 causes extra-intestinal infections, is often fluoroquinolone resistant and associated with
Extend-spectrum β-lactamase production especially CTX-M-15. K. pneumoniae ST258 causes
urinary and respiratory tract infections and is associated with carbapenemases most often KPC-2
and KPC-3. The most prevalent lineage within ST131 is named fimH30 because it contains the 2
H30 variant of the type 1 fimbrial adhesin gene and recent molecular studies have demonstrated
that this lineage emerged in early 2000‟s and was then followed by the rapid expansion of its
sublineages H30-R and H30-Rx. K. pneumoniae ST258 comprises of 2 distinct lineages namely
clade I and clade II. Moreover, it seems that ST258 is a hybrid clone that was created by a large
recombination event between ST11 and ST442. Epidemic plasmids with blaCTX-M and blaKPC
belonging to the incompatiblity group F have contributed significantly to the success of these
clones. E. coli ST131 and K. pneumoniae ST258 are the quintessential examples of international
multidrug-resistant high risk clones.
Description
Keywords
International high-risk clones, Spread of multidrug, Enterobacteriaceae, Epidemic resistance plasmids
Sustainable Development Goals
Citation
Mathers, AJ, Peirano, G & Pitout, JDD 2015, 'The role of epidemic resistance plasmids and international high-risk clones in the spread of multidrug-resistant Enterobacteriaceae', Clinical Microbiology Reviews, vol. 28, no. 3, pp. 565-591.