Escherichia coli ST131 clones harbouring AggR and AAF/V fimbriae causing bacteremia in Mozambican children: Emergence of new variant of fimH27 subclone
Open Access
- 1 May 2020
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLoS Neglected Tropical Diseases
- Vol. 14 (5), e0008274
- https://doi.org/10.1371/journal.pntd.0008274
Abstract
Multidrug-resistant Escherichia coli ST131 fimH30 responsible for extra-intestinal pathogenic (ExPEC) infections is globally distributed. However, the occurrence of a subclone fimH27 of ST131 harboring both ExPEC and enteroaggregative E. coli (EAEC) related genes and belonging to commonly reported O25:H4 and other serotypes causing bacteremia in African children remain unknown. We characterized 325 E. coli isolates causing bacteremia in Mozambican children between 2001 and 2014 by conventional multiplex polymerase chain reaction and whole genome sequencing. Incidence rate of EAEC bacteremia was calculated among cases from the demographic surveillance study area. Approximately 17.5% (57/325) of isolates were EAEC, yielding an incidence rate of 45.3 episodes/105 children-years-at-risk among infants; and 44 of isolates were sequenced. 72.7% (32/44) of sequenced strains contained simultaneously genes associated with ExPEC (iutA, fyuA and traT); 88.6% (39/44) harbored the aggregative adherence fimbriae type V variant (AAF/V). Sequence type ST-131 accounted for 84.1% (37/44), predominantly belonging to serotype O25:H4 (59% of the 37); 95.6% (35/44) harbored fimH27. Approximately 15% (6/41) of the children died, and five of the six yielded ST131 strains (83.3%) mostly (60%; 3/5) due to serotypes other than O25:H4. We report the emergence of a new subclone of ST-131 E. coli strains belonging to O25:H4 and other serotypes harboring both ExPEC and EAEC virulence genes, including agg5A, associated with poor outcome in bacteremic Mozambican children, suggesting the need for prompt recognition for appropriate management. Escherichia coli ST131 has emerged as a globally disseminated multi-drug resistant clone associated with extra-intestinal infections acquired in the community or hospital. In Manhiça district, E. coli is among the top five leading bloodstream pathogens in children. We characterized E. coli strains causing bacteremia in young children in a rural hospital of Mozambique, providing novel information on the occurrence of a new subclone of ST131 harboring both ExPEC and EAEC related genes and belonging to commonly reported O25:H4 and other serotypes. These data suggest the need for further understanding of pathogenesis and clinical impact of this new entity to inform prompt recognition and appropriate treatment.Keywords
This publication has 44 references indexed in Scilit:
- Diagnostic Microbiologic Methods in the GEMS-1 Case/Control StudyClinical Infectious Diseases, 2012
- Enteroaggregative Escherichia coli O78:H10, the Cause of an Outbreak of Urinary Tract InfectionJournal of Clinical Microbiology, 2012
- High HIV prevalence in a southern semi‐rural area of Mozambique: a community‐based surveyHIV Medicine, 2012
- Genomic Characterization of Enteroaggregative Escherichia coli From Children in MaliThe Journal of Infectious Diseases, 2011
- Antimicrobial Drug Resistance Trends of Bacteremia Isolates in a Rural Hospital in Southern MozambiqueThe American Journal of Tropical Medicine and Hygiene, 2010
- Molecular epidemiology of Escherichia coli producing extended-spectrum β-lactamases in Lugo (Spain): dissemination of clone O25b:H4-ST131 producing CTX-M-15Journal of Antimicrobial Chemotherapy, 2009
- Evolution of the iss Gene in Escherichia coliApplied and Environmental Microbiology, 2008
- Virulence Factors in Escherichia coliJournal of Clinical Microbiology, 2005
- Burden of Community‐OnsetEscherichia coliBacteremia in SeniorsThe Journal of Infectious Diseases, 2005
- Pathogenic Escherichia coliNature Reviews Microbiology, 2004