Extended-spectrum β-lactamase-producing Escherichia coli in human-derived and foodchain-derived samples from England, Wales, and Scotland: an epidemiological surveillance and typing study

Abstract

Background Extended-spectrum β-lactamase-producing Escherichia coli isolates (ESBL-E coli) cause more than 5000 cases of bacteraemias annually in the UK. The contribution of the food chain to these infections is debated. We aimed to identify the most important reservoirs of ESBL-E coli that colonise and infect humans to identify strategic intervention points.Methods Sampling for ESBL-E coli was done between Aug 1, 2013, and Dec 15, 2014. We used selective media to seek ESBL-E coli in routinely submitted samples from human faeces, and prospectively collected samples from sewage, farm slurry, and retail foodstuffs in London, East Anglia, northwest England, Scotland, and Wales. We sequenced recovered isolates and compared these isolates with 293 bloodstream and 83 veterinary surveillance ESBL-E coli isolates from the same regions. Findings 2157 (11%) of 20 243 human faeces samples contained ESBL-E coli, including 678 (17%) of 3995 in London. ESBL-E coli also were frequent in sewage and retail chicken (104 [65%] of 159 meat samples), but were rare in other meats and absent from plant-based foods (0 of 400 fruit and vegetable samples). Sequence type (ST) 131 dominated among ESBL-E coli from human blood (188 [64%] of 293 isolates), faeces (128 [36%] of 360), and sewage (14 [22%] of 65) with STs 38 and 648 also widespread; CTX-M-15 was the predominant ESBL in these lineages (319 [77%] of 416). By contrast, STs 602, 23, and 117-mostly with CTX-M-1 ESBL-dominated among food and veterinary isolates (68 [31%] of 218), with only two ST131 organisms recovered. ST10 occurred in both animals and humans, being frequent in surveillance bovines (11 [22%] of 51 cattle) and representing 15 (4%) of 360 human faecal isolates (but only three [1%] of 293 from bacteraemias); however, both human and animal ST10 isolates were diverse in serotype. Interpretation Most human bacteraemias with ESBL-E coli in the UK involve internationally prevalent humanassociated STs, particularly ST131; non-human reservoirs made little contribution to invasive human disease. Any interventions that seek to target food or livestock can affect the numbers of human infections caused by ESBL-E coli; prevention of the spread of resistant lineages among humans is more vital.

Prevalence and Molecular Characteristics of Extended-Spectrum and AmpC β-Lactamase Producing Escherichia coli in Grazing Beef Cattle

“…ST10 was the predominant MLST, and ST10 has been reported from clinical samples indicating the ST10 isolates can colonize in humans as well as animal (Wang et al, 2016). Recent study also found that ESBL-producing E. coli ST10 occurred in both humans and cattle, and CTX-M-14 was the predominant CTX-M type among the bovine isolates (Day et al, 2019). In the central area of Spain, ESBL-producing E. coli ST10 was disseminated carrying CTX-M-14 (Coque et al, 2008a), and another study showed that ST10 E. coli carried CTX-M-14, SHV-12, CTX-M-9, CTX-M-15, and CTX-M-32 (Oteo et al, 2009).…”

Whole-Genome Sequencing-Based Characteristics in Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Isolated from Retail Meats in Korea

“…Other prevalent clonal groups (ST93, ST602, and ST2170) in domestic meat samples were isolated from chicken meat; these groups were isolated from chicken samples procured from different companies. Of these STs, ST93 and ST602 were reported to be infrequent in humans but more frequent in animal samples (specifically chicken) [24,76,77], suggesting that the strains of groups ST93 and ST602 were present in chicken, since farming stages and chicken act as reservoirs for these clonal groups. ST2170 was previously reported in retail chicken meat and turkey in Japan and Ecuador, respectively [68,78].…”

Pan-resistome characterization of uropathogenic Escherichia coli and Klebsiella pneumoniae strains circulating in Uganda and Kenya isolated from 2017-2018

“…The widely-disseminated UTI-causing clones ST131, ST335 and ST10 were common among our E. coli strains and dominated our Kenyan collection. This is unsurprising as these ST's are reported to be circulating globally (Ben Zakour 2016; Sanjar et al 2015;Day et al 2019). What's remarkable is the detection .…”