Highlights
- •E. coli sequence type 131 accounts for many extraintestinal E. coli infections.
- •315 urine isolates from two medical centers in Minneapolis and Boston were compared.
- •Isolates exhibited predominantly B2 phylogenetic group and comparable ST131 prevalence.
- •Virulence genotypes varied significantly in relation to center and ST131 status.
- •The emerging C1-M27 subclone occurred uniquely among 6% of Boston isolates.
Background
Escherichia coli sequence type (ST) ST131, with its emergent resistance-associated H30Rx, H30R1, and C1-M27 clonal subsets, accounts for the greatest share of extraintestinal
E. coli infections and most extended-spectrum β-lactamase (ESBL)-producing E. coli.
Methods
We characterized and compared consecutive E. coli urine isolates from two geographically distinct medical centers in Minneapolis, Minnesota
(n = 172) and Boston, Massachusetts (n = 143) for ESBL phenotype, CTX-M-type ESBL
genes, phylogenetic groups, selected ST131 subclones, and 40 extraintestinal virulence
genes.
Results
Whereas the Boston vs. Minneapolis isolates had a similar prevalence of phylogenetic
groups (mainly B2: 79% vs 73%), ST131 (34% vs 28%), H30 (28% vs 21%), and H30Rx (6% vs 5%), the emerging C1-M27 subclone occurred uniquely among Boston (6%)
isolates. ESBL production was more prevalent among Boston isolates (15% vs 8%) and
among ST131 isolates. Identified ESBL genes included blaCTX-M-27 (Boston only) and blaCTX-M-15. Ciprofloxacin resistance was ST131-associated and similarly prevalent across centers.
Boston isolates had higher virulence gene scores.
Conclusions
Despite numerous similarities to Minneapolis isolates, Boston ST131 isolates demonstrated
more prevalent ESBL production, higher virulence gene scores, and, uniquely, the C1-M27
subclone and blaCTX-M-27. Broader surveillance is needed to define the prevalence of ST131′s globally successful
C1-M27 subclone across the U.S.
Key Words
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Article Info
Publication History
Published online: June 25, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding/Support: This research was supported in part by Office of Research and Development, Department of Veteran Affairs , grant # 2I01CX000920-04 (J.R.J).
Conflicts of interest: Elizabeth B. Hirsch has received research funding from Merck and advisory board honorarium from Melinta, MeMed, and Merck. James R. Johnson has had research grants and/or consultancies involving Achaogen, Allergan, Crucell/Janssen, Melinta, Merck, Shionogi, Syntiron, and Tetraphase, and has patent applications for tests to detect specific E. coli strains. All other authors declare no conflicts of interest.
Identification
Copyright
© 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
