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Multicenter Study
. 2024 Jan;30(1):20-28.
doi: 10.3201/eid3001.230851.

Early-Onset Infection Caused by Escherichia coli Sequence Type 1193 in Late Preterm and Full-Term Neonates

Célie Malaure, Guillaume Geslain, André Birgy, Philippe Bidet, Isabelle Poilane, Margaux Allain, Mathilde Liberge, Nizar Khattat, Paola Sikias, Stéphane Bonacorsi
Multicenter Study

Early-Onset Infection Caused by Escherichia coli Sequence Type 1193 in Late Preterm and Full-Term Neonates

Célie Malaure et al. Emerg Infect Dis. 2024 Jan.

Abstract

Using whole-genome sequencing, we characterized Escherichia coli strains causing early-onset sepsis (EOS) in 32 neonatal cases from a 2019-2021 prospective multicenter study in France and compared them to E. coli strains collected from vaginal swab specimens from women in third-trimester gestation. We observed no major differences in phylogenetic groups or virulence profiles between the 2 collections. However, sequence type (ST) analysis showed the presence of 6/32 (19%) ST1193 strains causing EOS, the same frequency as in the highly virulent clonal group ST95. Three ST1193 strains caused meningitis, and 3 harbored extended-spectrum β-lactamase. No ST1193 strains were isolated from vaginal swab specimens. Emerging ST1193 appears to be highly prevalent, virulent, and antimicrobial resistant in neonates. However, the physiopathology of EOS caused by ST1193 has not yet been elucidated. Clinicians should be aware of the possible presence of E. coli ST1193 in prenatal and neonatal contexts and provide appropriate monitoring and treatment.

Keywords: Escherichia coli; France; ST1193; ST95; antimicrobial resistance; bacteria; meningitis/encephalitis; molecular epidemiology; neonatal sepsis; sequence type; virulence; whole-genome sequencing.

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Figures

Figure 1
Figure 1
Phylogroup distribution among 32 EOS Escherichia coli strains from neonates and 50 HVC strains, France. No significant difference was observed in each group. EOS, early-onset neonatal sepsis; HVC, healthy vaginal carriage.
Figure 2
Figure 2
ST and STc distributions of EOS neonate and HVC Escherichia coli strains, France. STc14 distribution is detailed. STc10 includes ST10, ST13795, ST6826, and ST13957; STc59 includes ST59, ST415, and ST13796; STc11 includes ST73 and ST355; STc131 includes ST131 and ST2279. EOS, early-onset neonatal sepsis; HVC, healthy vaginal carriage; ST, sequence type; STc, ST complex.
Figure 3
Figure 3
Antibiotic resistance rates among EOS neonate and HVC Escherichia coli strains, France. AMX, amoxicillin; CIP, ciprofloxacin; CTX/COX, cefotaxime/ceftriaxone; EOS, early-onset neonatal sepsis; GTM, gentamicin; HVC, healthy vaginal carriage; NAL, nalidixic acid.
Figure 4
Figure 4
Phylogroup distributions according to birth term among 32 neonates with early-onset sepsis, France.
Figure 5
Figure 5
ST distributions according to birth term among 32 neonates with early-onset neonatal sepsis. ST, sequence type.
Figure 6
Figure 6
Distribution of maternal antimicrobial therapy within 3 days before delivery according to Escherichia coli ST among 32 neonates with early-onset neonatal sepsis, France. ST, sequence type.
See this image and copyright information in PMC

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