Molecular epidemiology of ESBL-producing <em>E. coli</em> and <em>K. pneumoniae</em>: establishing virulence clusters

Abstract

ObjectiveTo genetically characterize clusters of virulence factors (VFs) among extended spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae and assess whether these clusters are associated with genetic determinants or clinical outcomes.MethodsOne hundred forty-eight E. coli and 82 K. pneumoniae clinical isolates were obtained from 213 patients in Paris, France. Isolates underwent ESBL characterization, MultiLocus Sequence Typing (MLST) typing and phylogenetic group identification. Detection of ten E. coli and seven K. pneumoniae VF-encoding genes were assessed, from which a k-medians partition algorithm with Jaccard similarity measure was used to construct clusters.ResultsCTX-M was the predominant ESBL and susceptibility to trimethoprim–sulfamethoxazole (32%), ciprofloxacin (22%) and aminoglycosides (32%) was low. In E. coli, there were five identified clusters, with significantly different distributions of ESBL-sequence type (P<0.001), ST131 (P<0.001) and phylogenetic group (P=0.001) between clusters. “Siderophore exclusive”, “siderophore exclusive with iroN ” and “adhesin sfa/papGIII-rich” clusters had higher 12-month mortality rates compared to others (49% vs 22%, respectively, P=0.02). In K. pneumoniae, three different clusters, with significantly different distributions of aminoglycoside-sensitivity (P<0.004), MLST-type (P<0.001) and relaxase plasmids (P=0.001) were described.ConclusionDistinct clusters of E. coli and K. pneumoniae VFs are observed within ESBL-producing isolates and are strongly associated with several genetic determinants. Their association with overall morbidity and mortality requires further evidence.

Molecular epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae among children in China

“…In paediatric patients, both highly virulent carbapenemresistant K. pneumoniae and highly virulent disinfectantresistant K. pneumoniae have been reported, but there are few reports in the literature of K. pneumoniae strains that are resistant to both antibiotics and disinfectants (Candan and Aksöz 2015;Aygun et al 2019;Surgers et al 2019). In this study, it was found that all 34 CRKP strains carried virulence genes and disinfectant resistance genes.…”

“…In recent years, increasing attention has been given to K. pneumoniae, focusing on its high rate of drug resistance and high virulence. However, disinfectant resistance has received little attention among K. pneumoniae strains (Candan and Aksöz 2015;Aygun et al 2019;Surgers et al 2019).…”

Continuous Evolution: Perspective on the Epidemiology of Carbapenemase Resistance Among Enterobacterales and Other Gram-Negative Bacteria

“…These cephalosporins include cefotaxime, ceftriaxone, and ceftazidime, as well as the oxyimino-monobactam aztreonam. Cefotaximases, characterized by CTX-M genes arose by plasmid transfer from pre-existing chromosomal ESBL genes from the bacteria Kluyver a spp., [ 9 ] CTX-M ESBLs now represent a large proportion of global ESBL strains and are the dominant ESBLs in the US, particularly among urinary tract infections [ 10 , 10 ].…”

High Prevalence of ST131 Subclades C2-H30Rx and C1-M27 Among Extended-Spectrum β-Lactamase-Producing Escherichia coli Causing Human Extraintestinal Infections in Patients From Two Hospitals of Spain and France During 2015

“…In the present study, CTX-M-27 was significantly more frequent in Beaujon (15.6%) than in Lucus Augusti (6.5%). However, the Beaujon's CTX-M-27 percentage appeared as remarkably higher than those found before 2014 (4.5-5.4%) in other 19 hospitals located as Beaujon in the Paris area (Robin et al, 2017;Surgers et al, 2019). Inversely, this percentage was closer to that found between 2014 and 2017 in 24 pediatric centers located in six French regions, i.e., 12.4% among 251 ESBL-EC isolated from febrile urinary tract infections (FUTIs) (Birgy et al, 2020).…”