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Emergence of Enteroaggregative Escherichia coli within the ST131 Lineage as a Cause of Extraintestinal Infections.
- Source :
-
MBio [mBio] 2020 May 19; Vol. 11 (3). Date of Electronic Publication: 2020 May 19. - Publication Year :
- 2020
-
Abstract
- Escherichia coli sequence type 131 (ST131) is a major cause of urinary and bloodstream infections. Its association with extended-spectrum β-lactamases (ESBLs) significantly complicates treatment. Its best-described component is the rapidly expanding H 30Rx clade, containing allele 30 of the type 1 fimbrial adhesin gene fimH This lineage appears to have emerged in the United States and spread around the world in part due to the acquisition of the ESBL-encoding bla <subscript>CTX-M-15</subscript> gene and resistance to fluoroquinolones. However, non- H 30 ST131 sublineages with other acquired CTX-M-type resistance genes are also emerging. Based on whole-genome analyses, we describe here the presence of an ( fimH ) H 27 E. coli ST131 sublineage that has recently caused an outbreak of community-acquired bacteremia and recurrent urinary tract infections (UTIs) in Denmark. This sublineage has acquired both a virulence plasmid (pAA) that defines the enteroaggregative E. coli (EAEC) diarrheagenic pathotype and multiple genes associated with extraintestinal E. coli (ExPEC); combined, these traits have made this particular ST131 sublineage successful at colonizing its human host and causing recurrent UTI. Moreover, using a historic World Health Organization (WHO) E. coli collection and publicly available genome sequences, we identified a global H 27 EAEC ST131 sublineage that dates back as far as 1998. Most H 27 EAEC ST131 isolates harbor pAA or pAA-like plasmids, and our analysis strongly implies a single ancestral acquisition among these isolates. These findings illustrate both the profound plasticity of this important pathogenic E. coli ST131 H 27 sublineage and genetic acquisitions of EAEC-specific virulence traits that likely confer an enhanced ability to cause intestinal colonization. IMPORTANCE E. coli ST131 is an important extraintestinal pathogenic lineage. A signature characteristic of ST131 is its ability to asymptomatically colonize the gastrointestinal tract and then opportunistically cause extraintestinal infections, such as cystitis, pyelonephritis, and urosepsis. In this study, we identified an ST131 H 27 sublineage that has acquired the enteroaggregative diarrheagenic phenotype, spread across multiple continents, and caused multiple outbreaks of community-acquired ESBL-associated bloodstream infections in Denmark. The strain's ability to both cause diarrhea and innocuously colonize the human gastrointestinal tract may facilitate its dissemination and establishment in the community.<br /> (Copyright © 2020 Boll et al.)
- Subjects :
- Anti-Bacterial Agents pharmacology
Biological Specimen Banks
Community-Acquired Infections microbiology
Denmark
Drug Resistance, Multiple, Bacterial genetics
Escherichia coli drug effects
Genome, Bacterial
Humans
Multilocus Sequence Typing
Phylogeny
Plasmids genetics
Sequence Analysis, DNA
Virulence genetics
Whole Genome Sequencing
World Health Organization
Bacteremia microbiology
Escherichia coli genetics
Escherichia coli pathogenicity
Escherichia coli Infections microbiology
Urinary Tract Infections microbiology
Subjects
Details
- Language :
- English
- ISSN :
- 2150-7511
- Volume :
- 11
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- MBio
- Publication Type :
- Academic Journal
- Accession number :
- 32430467
- Full Text :
- https://doi.org/10.1128/mBio.00353-20