Abstract

Recurrent urinary tract infections (rUTIs) are extremely common, with ~ 25% of all women experiencing a recurrence within 1 year of their original infection. Escherichia coli ST131 is a globally dominant multidrug resistant clone associated with high rates of rUTI. Here, we show the dynamics of an ST131 population over a 5-year period from one elderly woman with rUTI since the 1970s. Using whole genome sequencing, we identify an indigenous clonal lineage (P1A) linked to rUTI and persistence in the fecal flora, providing compelling evidence of an intestinal reservoir of rUTI. We also show that the P1A lineage possesses substantial plasmid diversity, resulting in the coexistence of antibiotic resistant and sensitive intestinal isolates despite frequent treatment. Our longitudinal study provides a unique comprehensive genomic analysis of a clonal lineage within a single individual and suggests a population-wide resistance mechanism enabling rapid adaptation to fluctuating antibiotic exposure.

Details

Title
Population dynamics of an Escherichia coli ST131 lineage during recurrent urinary tract infection
Author
Forde, Brian M 1   VIAFID ORCID Logo  ; Roberts, Leah W 1 ; Minh-Duy Phan 2   VIAFID ORCID Logo  ; Peters, Kate M 2 ; Fleming, Brittany A 3 ; Russell, Colin W 3 ; Lenherr, Sara M 4 ; Myers, Jeremy B 4 ; Barker, Adam P 5 ; Fisher, Mark A 5 ; Teik-Min Chong 6 ; Wai-Fong, Yin 6 ; Kok-Gan, Chan 7   VIAFID ORCID Logo  ; Schembri, Mark A 2   VIAFID ORCID Logo  ; Mulvey, Matthew A 3 ; Beatson, Scott A 1   VIAFID ORCID Logo 

1  School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia; Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Queensland, Australia; Australian Centre for Ecogenomics, The University of Queensland, Brisbane, Queensland, Australia 
2  School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia; Australian Centre for Ecogenomics, The University of Queensland, Brisbane, Queensland, Australia 
3  Division of Microbiology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA 
4  Genitourinary Injury and Reconstructive Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA 
5  ARUP Laboratories and Department of Pathology, University of Utah, Salt Lake City, UT, USA 
6  Division of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia 
7  Division of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia; International Genome Centre, Jiangsu University, Zhenjiang, China 
Pages
1-10
Publication year
2019
Publication date
Aug 2019
Publisher
Nature Publishing Group
e-ISSN
20411723
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41467-019-11571-5
ProQuest document ID
2272720858
Copyright
© 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.