TY - JOUR
T1 - Extended-spectrum beta-lactamase (ESBL)-producing and non-ESBL-producing Escherichia coli isolates causing bacteremia in the Netherlands (2014 - 2016) differ in clonal distribution, antimicrobial resistance gene and virulence gene content
AU - van Hout, Denise
AU - Verschuuren, Tess D
AU - Bruijning-Verhagen, Patricia C J
AU - Bosch, Thijs
AU - Schürch, Anita C
AU - Willems, Rob J L
AU - Bonten, Marc J M
AU - Kluytmans, Jan A J W
N1 - Publisher Copyright:
© 2020 Hout et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background Knowledge on the molecular epidemiology of Escherichia coli causing E. coli bacteremia (ECB) in the Netherlands is mostly based on extended-spectrum beta-lactamase-producing E. coli (ESBL-Ec). We determined differences in clonality and resistance and virulence gene (VG) content between non-ESBL-producing E. coli (non-ESBL-Ec) and ESBL-Ec isolates from ECB episodes with different epidemiological characteristics. Methods A random selection of non-ESBL-Ec isolates as well as all available ESBL-Ec blood isolates was obtained from two Dutch hospitals between 2014 and 2016. Whole genome sequencing was performed to infer sequence types (STs), serotypes, acquired antibiotic resistance genes and VG scores, based on presence of 49 predefined putative pathogenic VG. Results ST73 was most prevalent among the 212 non-ESBL-Ec (N = 26, 12.3%) and ST131 among the 69 ESBL-Ec (N = 30, 43.5%). Prevalence of ST131 among non-ESBL-Ec was 10.4% (N = 22, P value < .001 compared to ESBL-Ec). O25:H4 was the most common serotype in both non-ESBL-Ec and ESBL-Ec. Median acquired resistance gene counts were 1 (IQR 1–6) and 7 (IQR 4–9) for non-ESBL-Ec and ESBL-Ec, respectively (P value < .001). Among non-ESBL-Ec, acquired resistance gene count was highest among blood isolates from a primary gastro-intestinal focus (median 4, IQR 1–8). Median VG scores were 13 (IQR 9–20) and 12 (IQR 8–14) for non-ESBL-Ec and ESBL-Ec, respectively (P value = .002). VG scores among non-ESBL-Ec from a primary urinary focus (median 15, IQR 11–21) were higher compared to non-ESBL-Ec from a primary gastro-intestinal (median 10, IQR 5–13) or hepatic-biliary focus (median 11, IQR 5–18) (P values = .007 and .04, respectively). VG content varied between different E. coli STs. Conclusions Non-ESBL-Ec and ESBL-Ec blood isolates from two Dutch hospitals differed in clonal distribution, resistance gene and VG content. Also, resistance gene and VG content differed between non-ESBL-Ec from different primary foci of ECB.
AB - Background Knowledge on the molecular epidemiology of Escherichia coli causing E. coli bacteremia (ECB) in the Netherlands is mostly based on extended-spectrum beta-lactamase-producing E. coli (ESBL-Ec). We determined differences in clonality and resistance and virulence gene (VG) content between non-ESBL-producing E. coli (non-ESBL-Ec) and ESBL-Ec isolates from ECB episodes with different epidemiological characteristics. Methods A random selection of non-ESBL-Ec isolates as well as all available ESBL-Ec blood isolates was obtained from two Dutch hospitals between 2014 and 2016. Whole genome sequencing was performed to infer sequence types (STs), serotypes, acquired antibiotic resistance genes and VG scores, based on presence of 49 predefined putative pathogenic VG. Results ST73 was most prevalent among the 212 non-ESBL-Ec (N = 26, 12.3%) and ST131 among the 69 ESBL-Ec (N = 30, 43.5%). Prevalence of ST131 among non-ESBL-Ec was 10.4% (N = 22, P value < .001 compared to ESBL-Ec). O25:H4 was the most common serotype in both non-ESBL-Ec and ESBL-Ec. Median acquired resistance gene counts were 1 (IQR 1–6) and 7 (IQR 4–9) for non-ESBL-Ec and ESBL-Ec, respectively (P value < .001). Among non-ESBL-Ec, acquired resistance gene count was highest among blood isolates from a primary gastro-intestinal focus (median 4, IQR 1–8). Median VG scores were 13 (IQR 9–20) and 12 (IQR 8–14) for non-ESBL-Ec and ESBL-Ec, respectively (P value = .002). VG scores among non-ESBL-Ec from a primary urinary focus (median 15, IQR 11–21) were higher compared to non-ESBL-Ec from a primary gastro-intestinal (median 10, IQR 5–13) or hepatic-biliary focus (median 11, IQR 5–18) (P values = .007 and .04, respectively). VG content varied between different E. coli STs. Conclusions Non-ESBL-Ec and ESBL-Ec blood isolates from two Dutch hospitals differed in clonal distribution, resistance gene and VG content. Also, resistance gene and VG content differed between non-ESBL-Ec from different primary foci of ECB.
KW - Antimicrobial resistance
KW - Blood
KW - Genetic epidemiology
KW - Escherichia coli
KW - Bacteremia
KW - Netherlands
KW - Vaccines
KW - Blood counts
UR - http://www.scopus.com/inward/record.url?scp=85077875908&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0227604
DO - 10.1371/journal.pone.0227604
M3 - Article
C2 - 31935253
SN - 1932-6203
VL - 15
SP - 1
EP - 14
JO - PLoS ONE
JF - PLoS ONE
IS - 1
M1 - e0227604
ER -