Genomic Analysis of CTX-M-Group-1-Producing Extraintestinal Pathogenic E. coli (ExPEc) from Patients with Urinary Tract Infections (UTI) from Colombia.

Elsa De La Cadena,Christian José Pallares,Nathaly Castillo,María Virginia Villegas,María Fernanda Mojica,Adriana Correa,Tobias Manuel Appel,Juan Carlos García-Betancur

doi:10.3390/antibiotics9120899

Abstract

Background: The dissemination of the uropathogenic O25b-ST131 Escherichia coli clone constitutes a threat to public health. We aimed to determine the circulation of E. coli strains belonging to O25b:H4-B2-ST131 and the H30-Rx epidemic subclone causing hospital and community-acquired urinary tract infections (UTI) in Colombia. Methods: Twenty-six nonduplicate, CTX-M group-1-producing isolates causing UTI in the hospital and community were selected for this study. Results: Twenty-two E. coli isolates harboring CTX-M-15, one CTX-M-3, and three CTX-M-55 were identified. Multilocus Sequence Typing (MLST) showed a variety of sequence types (STs), among which, ST131, ST405, and ST648 were reported as epidemic clones. All the E. coli ST131 sequences carried CTX-M-15, from which 80% belonged to the O25b:H4-B2 and H30-Rx pandemic subclones and were associated with virulence factors iss, iha, and sat. E. coli isolates (23/26) were resistant to ciprofloxacin and associated with amino acid substitutions in quinolone resistance-determining regions (QRDR). We detected two carbapenem-resistant E. coli isolates, one coproducing CTX-M-15, KPC-2, and NDM-1 while the other presented mutations in ompC. Additionally, one isolate harbored the gene mcr-1. Conclusions: Our study revealed the circulation of the E. coli ST131, O25b:H4-B2-H30-Rx subclone, harboring CTX-M-15, QRDR mutations, and other resistant genes. The association of the H30-Rx subclone with sepsis and rapid dissemination warrants attention from the public health and infections control.

Highlights

The spread of antimicrobial-resistant microorganisms has become a major threat to global public health, as infections caused by such bacteria are often responsible for the increase in patient mortalityAntibiotics 2020, 9, 899; doi:10.3390/antibiotics9120899 www.mdpi.com/journal/antibioticsAntibiotics 2020, 9, 899 and morbidity due to inappropriate therapy [1]
The acquisition of ESBLs is the main mechanism of resistance to oxyimino-cephalosporins in Escherichia coli, which are a major cause of hospital- and community-acquired urinary tract infections (UTI) [3]
Our results suggest that CIP resistance in E. coli ST131 in Colombia is associated with the lineages H30 and H35, which harbor a distinct gyrA and parC allele combination

Summary

Introduction

The spread of antimicrobial-resistant microorganisms has become a major threat to global public health, as infections caused by such bacteria are often responsible for the increase in patient mortalityAntibiotics 2020, 9, 899; doi:10.3390/antibiotics9120899 www.mdpi.com/journal/antibioticsAntibiotics 2020, 9, 899 and morbidity due to inappropriate therapy [1]. The spread of antimicrobial-resistant microorganisms has become a major threat to global public health, as infections caused by such bacteria are often responsible for the increase in patient mortality. The acquisition of ESBLs is the main mechanism of resistance to oxyimino-cephalosporins in Escherichia coli, which are a major cause of hospital- and community-acquired urinary tract infections (UTI) [3]. We aimed to determine the circulation of E. coli strains belonging to O25b:H4-B2-ST131 and the H30-Rx epidemic subclone causing hospital and community-acquired urinary tract infections (UTI) in Colombia. Methods: Twenty-six nonduplicate, CTX-M group-1-producing isolates causing UTI in the hospital and community were selected for this study. Conclusions: Our study revealed the circulation of the E. coli ST131, O25b:H4-B2-H30-Rx subclone, harboring CTX-M-15, QRDR mutations, and other resistant genes.

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