Abstract

BackgroundThis study was carried out to determine the prevalence and the genetic background of extended-spectrum β-lactamase-producing Escherichia coli invasive isolates obtained from a tertiary-care hospital in Budapest, Hungary.MethodsBetween October–November 2018, all invasive ESBL-producing E. coli isolates were collected from Central Hospital of Southern Pest. The antimicrobial susceptibility testing was performed according to the EUCAST guidelines. The possible clonal relationships were investigated by core genome (cg)MLST (SeqSphere +) using whole-genome sequencing (WGS) data of isolates obtained from Illumina 251-bp paired-end sequencing. From WGS data acquired antimicrobial resistance genes, virulence genes and replicon types were retrieved using ResFinder3.1, PlasmidFinder2.1, pMLST-2.0, VirulenceFinder2.0 and Virulence Factors Database online tools.ResultsOverall, six E. coli isolates proved to be resistant to third-generation cephalosporins and ESBL-producers in the study period. Full genome sequence analysis showed that five E. coli isolates belonged to the ST131 clone: two to C1-M27 subclade with blaCTX-M-27 and three to C2/H30Rx subclade with blaCTX-M-15. One isolate belonged to ST1193 with blaCTX-M-27. According to cgMLST, all C2/H30Rx isolates formed a cluster (≤ 6 allele differences), while the blaCTX-M-27-producing C1-M27 isolates differed at least 35 alleles from each other. Both C2/H30Rx and C1-M27 ST131 isolates harbored similar antimicrobial resistance gene sets. However, only C2/H30Rx isolates had the qnrB and aac(3)-IIa. The isolates carried similar extraintestinal virulence gene set but differed in some genes encoding siderophores, protectins and toxins. Moreover, only one C2/H30Rx isolate carried salmochelin siderophore system and showed virotype B. All isolates showed resistance against ceftriaxone, cefotaxime, and ciprofloxacin, and the C2/H30Rx isolates were also resistant to gentamicin, tobramycin, and ceftazidime.ConclusionsOut of six ESBL-producing E. coli, five belonged to the ST131 clone. This study indicates, that the C2/H30Rx and C1-M27 subclades of the ST131 appear to be the dominant clones collected in a Hungarian hospital.

Highlights

  • This study was carried out to determine the prevalence and the genetic background of extendedspectrum β-lactamase-producing Escherichia coli invasive isolates obtained from a tertiary-care hospital in Budapest, Hungary

  • E. coli sequence type 131 (ST131) high-risk clones connected with extended-spectrum β-lactamase (ESBL) production and fluoroquinolone resistance causing multidrugresistant infections belong to the most prevalent clade C associated with fimH30

  • Within C/H30, two subclades were emerging in the 2000s: C1/H30R subclade with fluoroquinolone resistance (FQ-R) and C2/H30Rx subclade with blaCTX-M-15, and FQ-R [3, 4]

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Summary

Introduction

This study was carried out to determine the prevalence and the genetic background of extendedspectrum β-lactamase-producing Escherichia coli invasive isolates obtained from a tertiary-care hospital in Budapest, Hungary. Among the most worrying multidrug resistant bacteria the burden of disease caused by third-generation cephalosporin-resistant Escherichia coli increased the most, in terms of the number of infections and. E. coli ST131 high-risk clones connected with extended-spectrum β-lactamase (ESBL) production and fluoroquinolone resistance causing multidrugresistant infections belong to the most prevalent clade C associated with fimH30. Within C/H30, two subclades were emerging in the 2000s: C1/H30R subclade with fluoroquinolone resistance (FQ-R) and C2/H30Rx subclade with blaCTX-M-15, and FQ-R [3, 4]. In the late 2000s, C1-M27 clade with blaCTX-M-27 of C1/H30R became dominant in Asia and showed global distribution like the C2/H30Rx did before [4]. The other recently emerging high-risk clones among ESBLproducing E. coli are ST10, ST38, ST69, ST155, ST315, ST405, ST410, ST648, and ST1193 [7,8,9,10]

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