Antimicrobial Resistance Profiling and Molecular Epidemiological Analysis of Extended Spectrum β-Lactamases Produced by Extraintestinal Invasive Escherichia coli Isolates From Ethiopia: The Presence of International High-Risk Clones ST131 and ST410 Revealed

Abstract

The treatment of invasive Escherichia coli infections is a challenge because of the emergence and rapid spread of multidrug resistant strains. Particular problems are those strains that produce extended spectrum β-lactamases (ESBL’s). Although the global characterization of these enzymes is advanced, knowledge of their molecular basis among clinical E. coli isolates in Ethiopia is extremely limited. This study intends to address this knowledge gap. The study combines antimicrobial resistance profiling and molecular epidemiology of ESBL genes among 204 E. coli clinical isolates collected from patient urine, blood, and pus at four geographically distinct health facilities in Ethiopia. All isolates exhibited multidrug resistance, with extensive resistance to ampicillin and first to fourth line generation cephalosporins and sulfamethoxazole-trimethoprim and ciprofloxacin. Extended spectrum β-lactamase genes were detected in 189 strains, and all but one were positive for CTX-Ms β-lactamases. Genes encoding for the group-1 CTX-Ms enzymes were most prolific, and CTX-M-15 was the most common ESBL identified. Group-9 CTX-Ms including CTX-M-14 and CTX-27 were detected only in 12 isolates and SHV ESBL types were identified in just 8 isolates. Bacterial typing revealed a high amount of strains associated with the B2 phylogenetic group. Crucially, the international high risk clones ST131 and ST410 were among the sequence types identified. This first time study revealed a high prevalence of CTX-M type ESBL’s circulating among E. coli clinical isolates in Ethiopia. Critically, they are associated with multidrug resistance phenotypes and high-risk clones first characterized in other parts of the world.

Comparative Analysis of Phylogenetic Relationships and Virulence Factor Characteristics between Extended-Spectrum β-Lactamase-Producing Escherichia coli Isolates Derived from Clinical Sites and Chicken Farms

“…Integrated with bla CTX-M subtype analysis, bla CTX-M-27 was primarily distributed in ST131, ST1193, ST1163, and ST398. Unlike the global epidemic ST131, which was prone to carry bla CTX-M-15 ( 32 ), we found that ST131 is prone to carry bla CTX-M-27 . bla CTX-M-14 is primarily distributed in ST12, ST410, and ST648 and has a stronger correlation with ST12.…”

Characterization of plasmids carrying blaCTX-M genes among extra-intestinal Escherichia coli clinical isolates in Ethiopia

“…Without unambiguous and up-to-date data on this, effective tracking and management of virulent E. coli is not feasible. We have recently published a phenotypic characterization of CTX-M-positive E. coli clinical isolates from four geographically distinct healthcare settings in Ethiopia 11 . The study reported on the different E. coli phylo-groups with several isolates belonging to the international high risk ST131 clone 11 .…”

The First Report of Escherichia coli and Klebsiella pneumoniae Strains That Produce Both NDM-5 and OXA-181 in Jiangsu Province, China

“…), Asia (South Korea, 32 Singapore, 33 India, 34 China, 35 etc. ), Africa, 36 North America (United States, 37 Mexico, 38 etc.) and South America (Brazil, 39 Chile 40 et al), etc.…”