Antimicrobial Resistance and Molecular Epidemiology of Escherichia coli From Bloodstream Infection in Shanghai, China, 2016–2019

Abstract

Background: Bloodstream infections are recognized as important nosocomial infections. Escherichia coli (E. coli) is the most prevalent Gram-negative bacillary pathogen causing bloodstream infections (BSIs). This retrospective study investigated drug susceptibility and molecular epidemiology of E. coli isolated from patients with BSI in Shanghai, China.Methods: We collected E. coli isolated from the blood cultures of patients with BSI between January 2016 and December 2019. We randomly selected 20 strains each year to investigate antimicrobial resistance, resistance genes, and molecular epidemiological characteristics. Antimicrobial susceptibility testing was performed by the disk diffusion method. PCR was performed to detect extended-spectrum β-lactamases (ESBLs), carbapenemase genes, and housekeeping genes, and phyloviz was applied to analyze multilocus sequence typing (MLST).Results: Penicillins, first- and second-generation cephalosporins and fluoroquinolones have high resistance rates (>60%). Among the 80 randomly selected strains, 47 (58.8%) produced ESBLs, and one produced carbapenemase. Sequencing of resistance genes identified blaCTX−M−14 (34%, 16/47), blaCTX−M−15 (23.4%, 11/47) and blaCTX−M−27 (14.8%, 7/47) as the most prevalent genotypes of ESBLs. ST131 (14/80) was the most prevalent sequence type (ST), followed by ST1193 (10/80), ST648 (7/80).Conclusions: Our findings suggest that amikacin, carbapenems, and piperacillin-tazobactam have relatively low resistance rates and may be the preferred antibiotic regimens for empiric therapy. ST131 and blaCTX−M−14 are still the main prevalent in Shanghai with a rapid increase in the occurrence of ST1193 is rapidly increasing and more diverse blaCTX genes.

Antibiogram Study of Bacteria Isolated from Subclinical Mastitis in Dairy Cattle of Kirtipur and Chandragiri Municipalities, Kathmandu, Nepal

“…Comparing with our finding Kahlmeter, (2003) found that E. coli isolates from human urinary tract infections were highly susceptible to Nitrofurantoin, Fosfomycin, and Mecillinam, while susceptibility to Trimethoprim/Sulfamethoxazole, Ciprofloxacin, and Gentamicin varied. Consistence with our finding, other studies on E. coli by Xiao et al (2022). Paudel et al (2023) showed high susceptibility to Imipenem and Amikacin, but lower susceptibility to Ampicillin, and Levofloxacin.…”

Comparative Analysis of Phylogenetic Relationships and Virulence Factor Characteristics between Extended-Spectrum β-Lactamase-Producing Escherichia coli Isolates Derived from Clinical Sites and Chicken Farms

“…This work investigated the genomic characteristics of ESBL- E. coli isolated from chicken farms and human medical clinics of Sichuan Province and Yunnan Province, China. The isolation rate of ESBL- E. coli in Sichuan Province was 48% (48/100), whereas that in Yunnan Province was 45.35% (156/344); both were slightly lower than the 58.8% rate in Shanghai ( 36 ). We found that the prevalence rate of chicken farm-derived ESBL- E. coli was 34.34% (204/594), which was significantly lower than the 78.6% reported by Liu et al ( 37 ).…”

ESBL-Producing and Non-ESBL-Producing Escherichia coli Isolates from Urinary Tract Differ in Clonal Distribution, Virulence Gene Content and Phylogenetic Group

“…In recent times, the ST131 clone has emerged as the foremost and highly potent multi-drug resistant (MDR) clone on a global scale, serving as a major etiological factor for community-acquired urinary and bacteremic infections. 20 , 21 ST1193 clone follows closely due to its prevalent overuse of Fluoroquinolone (FQ) and third-generation cephalosporin. 22 Birgy et al 23 revealed that ST1193 constituted one of the most prevalent clones during the final study phase, among 218 ESBL-producing E. coli infections that resulted in febrile urinary tract infections in children between 2014 and 2017.…”