ArticleResearch square2025
Spatial clusters of dominant lineages of uropathogenic Escherichia coli in a community dwelling patient population.
Article in Research square, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Antimicrobial resistance (AMR) is a major public health concern, especially in the clinical management of urinary tract infections (UTIs). While use of antimicrobial agents selects for AMR bacterial strains, it remains unclear if this factor alone drives the prevalence of UTIs caused by AMR uropathogenic Methods: We collected 551 UPEC isolates from patients receiving care in a San Francisco public healthcare system from April to September 2019. Isolates underwent multiplex PCR for rapid identification of pandemic UPEC STs (ST69, ST73, ST95, ST131) and were linked with electronic health records data. We conducted Global Moran's I and Local Moran's I to detect spatial clusters of each pandemic ST lineage. Results: Forty five percent of UPEC isolates (N = 247) were identified as pandemic ST lineages. ST131 comprised 72 (29%) of the pandemic ST lineages and contributed the most multidrug resistant isolates (resistant to ≥ 3 classes of antibiotics) (N = 29). Spatial clusters of ST95, ST131 and ST69 (p < 0.001, p < 0.001, p = 0.008, respectively) were identified. Conclusion: We found spatial clusters of community-onset bacteriuria caused by predominant ST lineages, suggesting common-source outbreaks. This novel approach may inform future surveillance efforts to reduce community transmission of AMR UPEC and provides the basis for future investigations of environmental risk factors for AMR UTI.
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