Genomic characterization of endemic diarrheagenic Escherichia coli and Escherichia albertii from infants with diarrhea in Vietnam

PLoS Negl Trop Dis. 2023 Apr 4;17(4):e0011259. doi: 10.1371/journal.pntd.0011259. eCollection 2023 Apr.

Abstract

Background: Diarrheagenic Escherichia coli (DEC) is a group of bacterial pathogens that causes life-threatening diarrhea in children in developing countries. However, there is limited information on the characteristics of DEC isolated from patients in these countries. A detailed genomic analysis of 61 DEC-like isolates from infants with diarrhea was performed to clarify and share the characteristics of DEC prevalent in Vietnam.

Principal findings: DEC was classified into 57 strains, including 33 enteroaggregative E. coli (EAEC) (54.1%), 20 enteropathogenic E. coli (EPEC) (32.8%), two enteroinvasive E. coli (EIEC) (3.3%), one enterotoxigenic E. coli (ETEC), and one ETEC/EIEC hybrid (1.6% each), and surprisingly into four Escherichia albertii strains (6.6%). Furthermore, several epidemic DEC clones showed an uncommon combination of pathotypes and serotypes, such as EAEC Og130:Hg27, EAEC OgGp9:Hg18, EAEC OgX13:H27, EPEC OgGp7:Hg16, and E. albertii EAOg1:HgUT. Genomic analysis also revealed the presence of various genes and mutations associated with antibiotic resistance in many isolates. Strains that demonstrate potential resistance to ciprofloxacin and ceftriaxone, drugs recommended for treating childhood diarrhea, accounted for 65.6% and 41%, respectively.

Significance: Our finding indicate that the routine use of these antibiotics has selected resistant DECs, resulting in a situation where these drugs do not provide in therapeutic effects for some patients. Bridging this gap requires continuous investigations and information sharing regarding the type and distribution of endemic DEC and E. albertii and their antibiotic resistance in different countries.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Diarrhea / epidemiology
  • Diarrhea / microbiology
  • Enteropathogenic Escherichia coli* / genetics
  • Enterotoxigenic Escherichia coli* / genetics
  • Escherichia
  • Escherichia coli Infections* / microbiology
  • Genomics
  • Humans
  • Infant
  • Vietnam / epidemiology

Supplementary concepts

  • Escherichia albertii

Grants and funding

This research was partially supported by the Grants of Joint Usage / Research Center on Tropical Disease, Institute of Tropical Medicine, Nagasaki University (2020-Ippan-10, 2021-Ippan-07, 2022-Kyoten-04) to AI. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.