The higher prevalence of extended spectrum beta-lactamases among Escherichia coli ST131 in Southeast Asia is driven by expansion of a single, locally prevalent subclone

• Published in: Scientific reports 2019-09, Vol.9 (1), p.13245-14, Article 13245
• Main Authors: Chen, Swaine L., Ding, Ying, Apisarnthanarak, Anucha, Kalimuddin, Shirin, Archuleta, Sophia, Omar, Sharifah Faridah Syed, De, Partha Pratim, Koh, Tse Hsien, Chew, Kean Lee, Atiya, Nadia, Suwantarat, Nuntra, Velayuthan, Rukumani Devi, Wong, Joshua Guo Xian, Lye, David C.
• Format: Article
• Language: English
• Subjects: 45/23; 631/326/325/1506; 692/699/255/1318; Anti-Bacterial Agents - pharmacology; Antibiotic resistance; Asia, Southeastern - epidemiology; beta-Lactamases - metabolism; Drug Resistance, Multiple, Bacterial; E coli; Escherichia coli; Escherichia coli - enzymology; Escherichia coli - genetics; Escherichia coli - isolation & purification; Escherichia coli Infections - drug therapy; Escherichia coli Infections - epidemiology; Escherichia coli Infections - genetics; Escherichia coli Infections - microbiology; Genome, Bacterial; Humanities and Social Sciences; Humans; multidisciplinary; Multilocus Sequence Typing; Prevalence; Risk factors; Science; Virulence; Virulence - drug effects; Virulence Factors
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-49467-5

The ST131 multilocus sequence type (MLST) of Escherichia coli is a globally successful pathogen whose dissemination is increasing rates of antibiotic resistance. Numerous global surveys have demonstrated the pervasiveness of this clone; in some regions ST131 accounts for up to 30% of all E . coli isolates. However, many regions are underrepresented in these published surveys, including Africa, South America, and Asia. We collected consecutive bloodstream E . coli isolates from three countries in Southeast Asia; ST131 was the most common MLST type. As in other studies, the C2/H30Rx clade accounted for the majority of ST131 strains. Clinical risk factors were similar to other reported studies. However, we found that nearly all of the C2 strains in this study were closely related, forming what we denote the SEA-C2 clone. The SEA-C2 clone is enriched for strains from Asia, particularly Southeast Asia and Singapore. The SEA-C2 clone accounts for all of the excess resistance and virulence of ST131 relative to non-ST131 E . coli . The SEA-C2 strains appear to be locally circulating and dominant in Southeast Asia, despite the intuition that high international connectivity and travel would enable frequent opportunities for other strains to establish themselves.