TY - JOUR
T1 - Global distribution and epidemiologic associations of escherichia coli clonal group A, 1998-2007
AU - Johnson, James R.
AU - Menard, Megan E.
AU - Lauderdale, Tsai Ling
AU - Kosmidis, Chris
AU - Gordon, David
AU - Collignon, Peter
AU - Maslow, Joel N.
AU - Andrǎević, Arjana Tambić
AU - Kuskowski, Michael A.
PY - 2011/11
Y1 - 2011/11
N2 - Escherichia coli clonal group A (CGA) was first reported in 2001 as an emerging multidrug-resistant extraintestinal pathogen. Because CGA has considerable implications for public health, we examined the trends of its global distribution, clinical associations, and temporal prevalence for the years 1998-2007. We characterized 2,210 E. coli extraintestinal clinical isolates from 32 centers on 6 continents by CGA status for comparison with trimethoprim/sulfamethoxazole (TMP/SMZ) phenotype, specimen type, inpatient/outpatient source, and adult/child host; we adjusted for clustering by center. CGA prevalence varied greatly by center and continent, was strongly associated with TMP/SMZ resistance but not with other epidemiologic variables, and exhibited no temporal prevalence trend. Our findings indicate that CGA is a prominent, primarily TMP/ SMZ-resistant extraintestinal pathogen concentrated within the Western world, with considerable pathogenic versatility. The stable prevalence of CGA over time suggests full emergence by the late 1990s, followed by variable endemicity worldwide as an antimicrobial drug-resistant public health threat.
AB - Escherichia coli clonal group A (CGA) was first reported in 2001 as an emerging multidrug-resistant extraintestinal pathogen. Because CGA has considerable implications for public health, we examined the trends of its global distribution, clinical associations, and temporal prevalence for the years 1998-2007. We characterized 2,210 E. coli extraintestinal clinical isolates from 32 centers on 6 continents by CGA status for comparison with trimethoprim/sulfamethoxazole (TMP/SMZ) phenotype, specimen type, inpatient/outpatient source, and adult/child host; we adjusted for clustering by center. CGA prevalence varied greatly by center and continent, was strongly associated with TMP/SMZ resistance but not with other epidemiologic variables, and exhibited no temporal prevalence trend. Our findings indicate that CGA is a prominent, primarily TMP/ SMZ-resistant extraintestinal pathogen concentrated within the Western world, with considerable pathogenic versatility. The stable prevalence of CGA over time suggests full emergence by the late 1990s, followed by variable endemicity worldwide as an antimicrobial drug-resistant public health threat.
UR - http://www.scopus.com/inward/record.url?scp=84930484579&partnerID=8YFLogxK
U2 - 10.3201/eid1711.110488
DO - 10.3201/eid1711.110488
M3 - Article
SN - 1080-6040
VL - 17
SP - 2001
EP - 2009
JO - Emerging Infectious Diseases
JF - Emerging Infectious Diseases
IS - 11
ER -