1600. Sharing of Escherichia coli Sequence Type ST131 and other E. coli among Household (HH) Members
Session: Poster Abstract Session: Multidrug-Resistant Gram Negative Rods
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: E. coli ST131, a typically fluoroquinolone-resistant (FQ-R) and/or extended-spectrum beta-lactamase (ESBL)-positive extraintestinal pathogen, has emerged recently worldwide. Transmission of E. coli among HH members is well documented, but only anecdotally for ST131. We systematically assessed for intestinal co-colonization among HH members of patients with FQ-R E. coliclinical isolates.

Methods: Veterans with FQ-R E. coli clinical isolates and their HH members (humans and pets) underwent initial and follow-up stool cultures for E. coli (FQ-R and FQ-S). Isolates were tested for ST131 status and compared with one another and the index clinical isolate according to RAPD profiles. One representative per unique RAPD profile per sample underwent PFGE analysis.

Results: 10 HHs of veterans with FQ-R E. coli clinical isolates (of which 7 [70%] were ST131) were studied. The veteran’s index strain was documented in another HH member for 6 HHs (60%), at similar frequency for ST131 (4/7, 57%) and non-ST131 (2/3, 67%) strains. Additionally, sharing of a FQ-S strain was documented in 4 HHs (40%). Although initial strain sharing involved mainly index patients and spouses, in one HH two sons shared a FQ-S strain, and in another HH all members (index patient, spouse, and dog) shared the veteran’s ESBL-positive recurrent UTI ST131 strain. Six (60%) of the 10 households continued to share index strains (4 ST131, 2 non-ST131), 10 (100%) index patients still carried their index strains, and 2 (20%) shared the FQ-S strains (in one family, all household members including index patient, son and dog) in their stools on follow-up cultures. 

Conclusion: HH members of veterans with FQ-R E. coli clinical isolates (70% of which are ST131) are frequently co-colonized with the index strain or other E. coli, regardless of ST131 status. Within-HH transmission may facilitate dissemination of resistant E. coli and contribute to recurrent UTI.

Aylin Colpan, MD1, Connie Clabots2, James Tacklind, PhD2, Stephen Porter2 and James R. Johnson, MD1,2, (1)University of Minnesota, Minneapolis, MN, (2)Minneapolis VA Medical Center, Minneapolis, MN

Disclosures:

A. Colpan, None

C. Clabots, None

J. Tacklind, None

S. Porter, None

J. R. Johnson, None

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