Resistome and virulome of high-risk pandemic clones of multidrug-resistant extra-intestinal pathogenic Escherichia coli (ExPEC) isolated from tertiary healthcare settings in Uganda

PLoS One. 2023 Nov 22;18(11):e0294424. doi: 10.1371/journal.pone.0294424. eCollection 2023.

Abstract

Multi-drug resistant (MDR) globally disseminated extraintestinal pathogenic high-risk Escherichia coli (ExPEC) clones are threatening the gains in bacterial disease management. In this study, we evaluated the genomic structure including the resistome and virulome of the E. coli isolates from extraintestinal infections using whole genome sequencing (WGS). The results highlight that isolates were highly resistant (≥ 90.0%) to commonly used antibiotics (Ampicillin, Trimethoprim-Sulfamethoxazole, Nalidixic acid, and Piperacillin) and were less (<14%) resistant to last resort antibiotics; Imipenem (10.94%) and Meropenem (10.20%). A greater proportion of the E. coli isolates belonged to phylogroup B2 (30.52%) and phylogroup A (27.37%). The sequence types ST131 of phylogroup B2 (21.05%) and ST648 of phylogroup F (9.3%) were the dominant pandemic high-risk clones identified in addition to the ST1193, ST410, ST69, ST38, ST405, and ST10. Many of the isolates were MDR and most (64.58%) carried the blaCTX-M-15 gene for extended-spectrum β-lactamases. There was a high correlation between phylogroups and the occurrence of both antimicrobial resistance and virulence genes. The cephalosporin-resistance gene blaEC-5 was only found in phylogroup B2 while blaEC-8 and blaEC-19, were only found within phylogroup D and phylogroup F respectively. Aminoglycoside gene (aadA1) was only associated with phylogroups D and C. The isolates were armed with a broad range of virulence genes including adhesins, toxins, secreted proteases, iron uptake genes, and others. The yfcv, chuA, and kpsE genes preferentially occurred among isolates of phylogroup B2. The study underlines the predominance of MDR internationally disseminated high-risk ExPEC clones with a broad range of virulence genes known to be highly transmissible in healthcare and community settings.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Escherichia coli
  • Escherichia coli Infections* / drug therapy
  • Escherichia coli Infections* / epidemiology
  • Escherichia coli Infections* / microbiology
  • Escherichia coli Proteins* / genetics
  • Extraintestinal Pathogenic Escherichia coli*
  • Genotype
  • Humans
  • Membrane Transport Proteins / genetics
  • Pandemics
  • Tertiary Healthcare
  • Uganda
  • Virulence Factors / genetics
  • beta-Lactamases / genetics

Substances

  • Anti-Bacterial Agents
  • Virulence Factors
  • beta-Lactamases
  • kpsE protein, E coli
  • Membrane Transport Proteins
  • Escherichia coli Proteins

Grants and funding

This work was funded by the United States Armed Forces Health Surveillance Division (AFHSD) Global Emerging Infections Surveillance (GEIS) Branch under PROMIS ID P0119_18_KY_013.01 to DKB. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.