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Epidemiological characterization of a nosocomial outbreak of extended spectrum -lactamase Escherichia coli ST-131 confirms the clinical value of core genome multilocus sequence typing
Kalmar County Hospital, Sweden; Linnaeus University, Sweden.
Vaxjo Central Hospital, Sweden.
Div Medical Diagnost, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Kalmar County Hospital, Sweden; Linnaeus University, Sweden; Kalmar County Hospital, Sweden.
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2017 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 125, no 12, p. 1117-1124Article in journal (Refereed) Published
Abstract [en]

Enhanced precision of epidemiological typing in clinically suspected nosocomial outbreaks is crucial. Our aim was to investigate whether single nucleotide polymorphism (SNP) analysis and core genome (cg) multilocus sequence typing (MLST) of whole genome sequencing (WGS) data would more reliably identify a nosocomial outbreak, compared to earlier molecular typing methods. Sixteen isolates from a nosocomial outbreak of ESBL E.coli ST-131 in southeastern Sweden and three control strains were subjected to WGS. Sequences were explored by SNP analysis and cgMLST. cgMLST clearly differentiated between the outbreak isolates and the control isolates (amp;gt;1400 differences). All clinically identified outbreak isolates showed close clustering (2 allele differences), except for two isolates (amp;gt;50 allele differences). These data confirmed that the isolates with amp;gt;50 differing genes did not belong to the nosocomial outbreak. The number of SNPs within the outbreak was 7, whereas the two discrepant isolates had amp;gt;700 SNPs. Two of the ESBL E.coli ST-131 isolates did not belong to the clinically identified outbreak. Our results illustrate the power of WGS in terms of resolution, which may avoid overestimation of patients belonging to outbreaks as judged from epidemiological data and previously employed molecular methods with lower discriminatory ability.

Place, publisher, year, edition, pages
WILEY , 2017. Vol. 125, no 12, p. 1117-1124
Keywords [en]
Epidemiological typing; whole genome sequencing; Escherichia coli ST-131; single nucleotide polymorphism; cgMLST
National Category
Microbiology in the medical area
Identifiers
URN: urn:nbn:se:liu:diva-143729DOI: 10.1111/apm.12753ISI: 000416437400011PubMedID: 28960453OAI: oai:DiVA.org:liu-143729DiVA, id: diva2:1166736
Note

Funding Agencies|research council of South-east Sweden (FORSS); Marianne and Marcus Wallenberg foundation

Available from: 2017-12-15 Created: 2017-12-15 Last updated: 2018-01-13

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