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. 2018 Jul 27;62(8):e00266-18.
doi: 10.1128/AAC.00266-18. Print 2018 Aug.

Diversity of Carbapenemase-Producing Escherichia coli Isolates in France in 2012-2013

Lauraine Gauthier  1   2   3 , Laurent Dortet  1   2   3 , Garance Cotellon  3 , Elodie Creton  3 , Gaëlle Cuzon  1   2   3 , Valérie Ponties  4 , Rémy A Bonnin  2   3 , Thierry Naas  5   2   3
Affiliations

Diversity of Carbapenemase-Producing Escherichia coli Isolates in France in 2012-2013

Lauraine Gauthier et al. Antimicrob Agents Chemother. .

Abstract

With the dissemination of carbapenemase-producing Enterobacteriaceae (CPE) strains worldwide, carbapenem-hydrolyzing enzymes are increasingly reported among isolates of Escherichia coli, the first hospital and community-acquired opportunistic pathogen. Here, we have performed an epidemiological survey of carbapenemase-producing E. coli (CP-Ec) isolates received at the French National Reference Centre (F-NRC) in 2012 and 2013. Antimicrobial susceptibilities for last-resort antibiotics and antimicrobial compounds commonly used to treat urinary tract infections were determined by broth microdilution. Clonal relationship was assessed using repetitive sequence-based PCR (rep-PCR) and multilocus sequence typing (MLST). From this collection of 140 carbapenemase-producing E. coli isolates, 74% produced an OXA-48-like carbapenemase and 21% produced an NDM carbapenemase. A link with a foreign country was suspected for 37% of infected/colonized patients. Most of the isolates were from screening (56%) and from urine samples (26%). Colistin, fosfomycin, and nitrofurantoin possessed the most consistent activity, with 100%, 95%, and 96% isolates susceptible, respectively. A wide diversity of carbapenemase-producing E. coli isolates has been found (50 different sequence types [STs]). The most prevalent clones were (i) E. coli sequence type 38 (ST38) producing OXA-48 (n = 21), a clone linked to Turkey and North African countries, (ii) E. coli ST-90 producing OXA-204 (n = 9), which was responsible for an outbreak related to a contaminated duodenoscope, and (iii) E. coli ST-410 producing OXA-181 (n = 5), which was recovered from patients of different geographical origins. These specific clones might be considered high-risk clones for the dissemination of carbapenemases in E. coli The wide diversity of STs, combined with the increasing number of CP-Ec isolates received by the F-NRC, suggests a likely dissemination of CP-Ec isolates in the community.

Keywords: KPC; MLST; NDM; OXA-48; VIM; carbapenemase; epidemiology; molecular epidemiology; rep-PCR.

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Figures

FIG 1
FIG 1
Antimicrobial susceptibility of class-D-carbapenemase-producing E. coli (n = 103). x axis, MIC in mg/liter; y axis, number of isolates. A, ceftazidime; B, nitrofurantoin; C, fosfomycin; D, imipenem; E, amdinocillin; F, trimethoprim-sulfamethoxazole; S, susceptible; I, intermediate; R, resistant.
FIG 2
FIG 2
Diversity of sequence types (ST) among carbapenemase-producing E. coli isolates. Major STs are indicated in %; n, total number of isolates.
FIG 3
FIG 3
Comparisons of E. coli isolates by MLST and Diversilab methods. Gray boxes indicate clonal complexes. Number of isolates with an identical Diversilab pattern is indicated. Expressed carbapenemases are indicated for each Diversilab pattern. Numbers in parentheses correspond to the number of isolates with a given carbapenemase or multilocus sequence type.
See this image and copyright information in PMC

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