Molecular Epidemiology of Bloodstream Associated E. coli ST131 H30-Rx Subclone Infection in a Region with High Quinolone Resistance

Journal of Medical Microbiology
Fusun CanOnder Ergonul

Abstract

Bloodstream infections caused by E. coli ST131 and ST131 H30-Rx subclones have emerged worldwide. This study was carried out to evaluate the prevalence of ST131-Rx subclone and characterize the virulence properties of the Rx among the bloodstream E. coli isolates. A total of 297 non-duplicated E.coli bloodstream isolates were studied. Antibiotic susceptibilities were tested using the disk diffusion method. PCR amplification and sequencing was used to identify ST131 and H30-Rx, the virulence gene, the betalactamase, and virotype. Quinolone resistance among bacteremic E.coli strains was 51%, and it was 98% among E.coli ST131. The ST131 accounted for 16% (49) of all isolates and all ST131 isolates belonged to the ExpEC. The proportion of H30 subclone among the ST131 isolates was 98% and 75% of H30 isolates belonged to the H30-Rx. The prevalence of ST131 increased from 13% to 23% in 4 years; however, there was a decrease in the ratio of H30-Rx infections. CTX-M-15 was detected in 85% of ST131 and all of H30-Rx isolates. The virulence genes associated with adhesion, cell protection, iron uptake, and toxins (papA, iha , KpsmtII, iut, and sat) were more common in ST131 than in non-ST131. Most of the ST131 and H30-Rx isolates were of t...Continue Reading

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