Virulence and resistance properties of E. coli isolated from urine samples of hospitalized patients in Rio de Janeiro, Brazil – The role of mobile genetic elements

Extraintestinal pathogenic E. coli (ExPEC) is the most frequent etiological agent of urinary tract infections (UTIs). Particular evolutionary successful lineages are associated with severe UTIs and higher incidences of multidrug resistance. Most of the resistance genes are acquired by horizontal tra...

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Published in:	International journal of medical microbiology Vol. 310; no. 8; p. 151453
Main Authors:	da Cruz Campos, Ana Carolina, Couto, Natacha, Lucas da Silva Andrade, Nathália, Friedrich, Alex W., de Paula Rosa, Ana Cláudia, Vieira Damasco, Paulo, Chlebowicz-Fliss, Monika A., Rossen, John W.A.
Format:	Journal Article
Language:	English
Published:	Germany Elsevier GmbH 01-12-2020 Elsevier
Subjects:	beta-Lactamases - genetics Brazil Drug Resistance, Multiple, Bacterial - genetics E. coli Escherichia coli Infections - microbiology Escherichia coli Infections - urine Extraintestinal Pathogenic Escherichia coli - drug effects Extraintestinal Pathogenic Escherichia coli - genetics Extraintestinal Pathogenic Escherichia coli - pathogenicity Genomic islands Humans Pathogenicity islands Plasmids ST131 UTIs Virulence - genetics Brazil HPI VFDB HS ATCC UTIs BR Genomic islands ESBL MDR E. coli CGE PBS ST GI TSA MALDI-TOF MGE BRIG PAIDB Plasmids DNA LB Pathogenicity islands ST131 PAI dsDNA pMLST
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Summary:	Extraintestinal pathogenic E. coli (ExPEC) is the most frequent etiological agent of urinary tract infections (UTIs). Particular evolutionary successful lineages are associated with severe UTIs and higher incidences of multidrug resistance. Most of the resistance genes are acquired by horizontal transfer of plasmids and other mobile genetic elements (MGEs), and this process has been associated with the successful dissemination of particular lineages. Here, we identified the presence of MGEs and their role in virulence and resistance profiles of isolates obtained from the urine of hospitalized patients in Brazil. Isolates belonging to the successful evolutionary lineages of sequence type (ST) 131, ST405, and ST648 were found to be multidrug-resistant, while those belonging to ST69 and ST73 were often not. Among the ST131, ST405, and ST648 isolates with a resistant phenotype, a high number of mainly IncFII plasmids was identified. The plasmids contained resistance cassettes, and these were also found within phage-related sequences and the chromosome of the isolates. The resistance cassettes were found to harbor several resistance genes, including blaCTX-M-15. In addition, in ST131 isolates, diverse pathogenicity islands similar to those found in highly virulent ST73 isolates were detected. Also, a new genomic island associated with several virulence genes was identified in ST69 and ST131 isolates. In addition, several other MGEs present in the ST131 reference strain EC958 were identified in our isolates, most of them exclusively in ST131 isolates. In contrast, genomic islands present in this reference strain were only partially present or completely absent in our ST131 isolates. Of all isolates studied, ST73 and ST131 isolates had the most similar virulence profile. Overall, no clear association was found between the presence of specific MGEs and virulence profiles. Furthermore, the interplay between virulence and resistance by acquiring MGEs seemed to be lineage dependent. Although the acquisition of IncF plasmids, specific PAIs, GIs, and other MGEs seemed to be involved in the success of some lineages, it cannot explain the success of different lineages, also indicating other (host) factors are involved in this process. Nevertheless, the detection, identification, and surveillance of lineage-specific MGEs may be useful to monitor (new) emerging clones.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1438-4221 1618-0607
DOI:	10.1016/j.ijmm.2020.151453