Distribution of extraintestinal pathogenic Escherichia coli O-serotypes and antibiotic resistance in blood isolates collected from patients in a surveillance study in Japan

Matsumoto, Tetsuya; Mikamo, Hiroshige; Ohge, Hiroki; Yanagihara, Katsunori; Weerdenburg, Eveline; Go, Oscar; Spiessens, Bart; Geet, Gunter van; Hoven, Thijs van den; Momose, Atsushi; Hagiwara, Yosuke; Nakayama, Yoshikazu; Poolman, Jan; Geurtsen, Jeroen; Kaku, Mitsuo

doi:10.1016/j.jiac.2022.07.001

Cited by 6 publications

(5 citation statements)

References 31 publications

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“…Previously published studies 24 – 27 , as well as data described here, demonstrate that vaccines targeting the ExPEC O-antigen, a component of the surface lipopolysaccharide, are safe and immunogenic in humans. Surface O-antigens are important virulence factors contributing to ExPEC pathogenicity 23 , 28 .…”

Section: Discussionsupporting

confidence: 66%

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A randomized phase 1/2a trial of ExPEC10V vaccine in adults with a history of UTI

Fierro,

Sarnecki,

Spiessens

et al. 2024

npj Vaccines

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The safety, reactogenicity, and immunogenicity of 3 doses of ExPEC10V (VAC52416), a vaccine candidate to prevent invasive Escherichia coli disease, were assessed in a phase 1/2a study (NCT03819049). In Cohort 1, ExPEC10V was well tolerated; the high dose was selected as optimal and further characterized in Cohort 2. Cohort 2 comprised a maximum 28-day screening, vaccination (Day 1), double-blind 181-day follow-up, and open-label long-term follow-up until Year 1. Healthy participants (≥60 years) with a history of urinary tract infection (UTI) within 5 years were randomized to receive ExPEC10V or placebo. The primary endpoint evaluated the safety and reactogenicity of ExPEC10V (solicited local and systemic AEs [until Day 15]; unsolicited AEs [until Day 30], SAEs [until Day 181], and immunogenicity [Day 30]) via multiplex electrochemiluminescent (ECL) and multiplex opsonophagocytic assay (MOPA). 416 participants (ExPEC10V, n = 278; placebo, n = 138) were included (mean age [SD], 68.8 [6.52] years; female, 79.6%; White, 96.1%). The incidence of solicited AEs was higher with ExPEC10V (local, 50.0% [n = 139]; systemic, 50.0% [n = 139]) than placebo (15.9% [n = 22]; 38.4% [n = 53]); rates of unsolicited AEs were comparable (ExPEC10V, 28.4% [n = 79]; placebo, 26.1% [n = 36]). No vaccine-related SAEs or deaths were reported. ExPEC10V elicited a robust antibody-mediated immunogenic response across all serotypes with ECL (Day 30 geometric mean fold increase, 2.33–8.18) and demonstrated functional opsonophagocytic killing activity across all measured serotypes (Day 30 geometric mean fold increase, 1.81–9.68). ExPEC10V exhibited an acceptable safety profile and a robust vaccine-induced functional immunogenic response in participants with a history of UTI. Clinical trial registration details: https://clinicaltrials.gov/study/NCT03819049.

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Section: Discussionsupporting

confidence: 66%

“…ExPEC10V and its precursor ExPEC4V were designed to target the most common causative ExPEC serotypes driving IED 23 , 27 , 29 , 30 . ExPEC4V, a 4-valent E. coli bioconjugate vaccine, targeted ExPEC O-antigens O1A, O2, O6A, and O25B and was immunogenic across the 4 serotypes in healthy adults 25 , 26 , 31 .…”

Section: Discussionmentioning

confidence: 99%

A randomized phase 1/2a trial of ExPEC10V vaccine in adults with a history of UTI

Fierro,

Sarnecki,

Spiessens

et al. 2024

npj Vaccines

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“…In previous studies, various O-serogroups have been identified in ExPEC infections, and some O-serogroups were more prevalent in certain species. The serogroups O25, O2, O6, and O1 in patient samples were characterized by the presence of various virulence factors 51 – 53 . Isolated ExPEC samples from dogs and cats were grouped into serogroups O4 and O6 and characterized by the presence of various virulence factors 1 , 54 , specifically samples isolated from pneumonia-infected lungs of dogs 15 , 20 and cats 6 containing papA , hlyD , and cnf1 .…”

Section: Discussionmentioning

confidence: 99%

Characterization of the pathogenicity of extraintestinal pathogenic Escherichia coli isolates from pneumonia-infected lung samples of dogs and cats in South Korea

Yun

Moon

Hwang

et al. 2023

Sci Rep

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This study aimed to investigate the pathogenicity of extraintestinal pathogenic Escherichia coli (ExPEC) isolated from dog and cat lung samples in South Korea. A total of 101 E. coli isolates were analyzed for virulence factors, phylogroups, and O-serogroups, and their correlation with bacterial pneumonia-induced mortality was elucidated. P fimbriae structural subunit (papA), hemolysin D (hlyD), and cytotoxic necrotizing factor 1 (cnf1) were highly prevalent in both species, indicating correlation with bacterial pneumonia. Phylogroups B1 and B2 were the most prevalent phylogroups (36.6% and 32.7%, respectively) and associated with high bacterial pneumonia-induced mortality rates. Isolates from both species belonging to phylogroup B2 showed high frequency of papA, hlyD, and cnf1. O-serogrouping revealed 21 and 15 serogroups in dogs and cats, respectively. In dogs, O88 was the most prevalent serogroup (n = 8), and the frequency of virulence factors was high for O4 and O6. In cats, O4 was the most prevalent serogroup (n = 6), and the frequency of virulence factors was high for O4 and O6. O4 and O6 serogroups were mainly grouped under phylogroup B2 and associated with high bacterial pneumonia-induced mortality. This study characterized the pathogenicity of ExPEC and described the probability of ExPEC pneumonia-induced mortality.

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“…When resistant bacteria colonize the gastrointestinal tract, this provides an opportunity for transfer of resistance genes among pathogens and gut microbiome commensal bacteria ( 7 – 9 ). Multidrug-resistant Escherichia coli are a burden on healthcare systems and are often responsible for treatment failures in patients ( 10 – 12 ). However, the success of the globally prevalent E. coli sequence type 131 (ST131) is not explained simply by its antibiotic resistance profile and likely involves diverse colonization and virulence factors ( 13 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal genomic surveillance of multidrug-resistant Escherichia coli carriage in critical care patients

El Chaar,

Khoury,

Douglas

et al. 2024

Microbiol Spectr

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Colonization with multidrug-resistant Escherichia coli strains causes a substantial health burden in hospitalized patients. We performed a longitudinal genomics study to investigate the colonization of resistant E. coli strains in critically ill patients and to identify evolutionary changes and strain replacement events within patients. Patients were admitted to the intensive care unit and hematology wards at a major hospital in Lebanon. Perianal swabs were collected from participants on admission and during hospitalization, which were screened for extended-spectrum beta-lactamases and carbapenem-resistant Enterobacterales. We performed whole-genome sequencing and analysis on E. coli strains isolated from patients at multiple time points. The E. coli isolates were genetically diverse, with 11 sequence types (STs) identified among 22 isolates sequenced. Five patients were colonized by E. coli sequence type 131 (ST131)-encoding CTX-M-27, an emerging clone not previously observed in clinical samples from Lebanon. Among the eight patients whose resident E. coli strains were tracked over time, five harbored the same E. coli strain with relatively few mutations over the 5 to 10 days of hospitalization. The other three patients were colonized by different E. coli strains over time. Our study provides evidence of strain diversity within patients during their hospitalization. While strains varied in their antimicrobial resistance profiles, the number of resistance genes did not increase over time. We also show that ST131-encoding CTX-M-27, which appears to be emerging as a globally important multidrug-resistant E. coli strain, is also prevalent among critical care patients and deserves further monitoring. IMPORTANCE Understanding the evolution of bacteria over time in hospitalized patients is of utmost significance in the field of infectious diseases. While numerous studies have surveyed genetic diversity and resistance mechanisms in nosocomial infections, time series of within-patient dynamics are rare, and high-income countries are over-represented, leaving low- and middle-income countries understudied. Our study aims to bridge these research gaps by conducting a longitudinal survey of critically ill patients in Lebanon. This allowed us to track Escherichia coli evolution and strain replacements within individual patients over extended periods. Through whole-genome sequencing, we found extensive strain diversity, including the first evidence of the emerging E. coli sequence type 131 clone encoding the CTX-M-27 beta-lactamase in a clinical sample from Lebanon, as well as likely strain replacement events during hospitalization.

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Distribution of extraintestinal pathogenic Escherichia coli O-serotypes and antibiotic resistance in blood isolates collected from patients in a surveillance study in Japan

Cited by 6 publications

References 31 publications

A randomized phase 1/2a trial of ExPEC10V vaccine in adults with a history of UTI

A randomized phase 1/2a trial of ExPEC10V vaccine in adults with a history of UTI

Characterization of the pathogenicity of extraintestinal pathogenic Escherichia coli isolates from pneumonia-infected lung samples of dogs and cats in South Korea

Longitudinal genomic surveillance of multidrug-resistant Escherichia coli carriage in critical care patients

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