Extended-spectrum beta-lactamase (ESBL)-producing and non-ESBL-producing Escherichia coli isolates causing bacteremia in the Netherlands (2014 – 2016) differ in clonal distribution, antimicrobial resistance gene and virulence gene content

Autoři: Denise van Hout aff001;  Tess D. Verschuuren aff001;  Patricia C. J. Bruijning-Verhagen aff001;  Thijs Bosch aff002;  Anita C. Schürch aff003;  Rob J. L. Willems aff003;  Marc J. M. Bonten aff001;  Jan A. J. W. Kluytmans aff001
Působiště autorů: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands aff001;  Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands aff002;  Department of Medical Microbiology, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands aff003;  Microvida Laboratory for Medical Microbiology and Department of Infection Control, Amphia Hospital, Breda, The Netherlands aff004
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227604



Knowledge on the molecular epidemiology of Escherichia coli causing E. coli bacteremia (ECB) in the Netherlands is mostly based on extended-spectrum beta-lactamase-producing E. coli (ESBL-Ec). We determined differences in clonality and resistance and virulence gene (VG) content between non-ESBL-producing E. coli (non-ESBL-Ec) and ESBL-Ec isolates from ECB episodes with different epidemiological characteristics.


A random selection of non-ESBL-Ec isolates as well as all available ESBL-Ec blood isolates was obtained from two Dutch hospitals between 2014 and 2016. Whole genome sequencing was performed to infer sequence types (STs), serotypes, acquired antibiotic resistance genes and VG scores, based on presence of 49 predefined putative pathogenic VG.


ST73 was most prevalent among the 212 non-ESBL-Ec (N = 26, 12.3%) and ST131 among the 69 ESBL-Ec (N = 30, 43.5%). Prevalence of ST131 among non-ESBL-Ec was 10.4% (N = 22, P value < .001 compared to ESBL-Ec). O25:H4 was the most common serotype in both non-ESBL-Ec and ESBL-Ec. Median acquired resistance gene counts were 1 (IQR 1–6) and 7 (IQR 4–9) for non-ESBL-Ec and ESBL-Ec, respectively (P value < .001). Among non-ESBL-Ec, acquired resistance gene count was highest among blood isolates from a primary gastro-intestinal focus (median 4, IQR 1–8). Median VG scores were 13 (IQR 9–20) and 12 (IQR 8–14) for non-ESBL-Ec and ESBL-Ec, respectively (P value = .002). VG scores among non-ESBL-Ec from a primary urinary focus (median 15, IQR 11–21) were higher compared to non-ESBL-Ec from a primary gastro-intestinal (median 10, IQR 5–13) or hepatic-biliary focus (median 11, IQR 5–18) (P values = .007 and .04, respectively). VG content varied between different E. coli STs.


Non-ESBL-Ec and ESBL-Ec blood isolates from two Dutch hospitals differed in clonal distribution, resistance gene and VG content. Also, resistance gene and VG content differed between non-ESBL-Ec from different primary foci of ECB.

Klíčová slova:

Antimicrobial resistance – Bacteremia – Blood – Blood counts – Escherichia coli – Genetic epidemiology – Netherlands – Vaccines


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