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dc.contributor.authorRoer, Louise
dc.contributor.authorOverballe-Petersen, Søren
dc.contributor.authorHansen, Frank
dc.contributor.authorSchønning, Kristian
dc.contributor.authorWang, Mikala
dc.contributor.authorRøder, Bent L
dc.contributor.authorHansen, , Dennis S
dc.contributor.authorJustesen, Ulrik S
dc.contributor.authorAndersen, Leif P
dc.contributor.authorFulgsang-Damgaard, David
dc.contributor.authorHopkins, Katie L
dc.contributor.authorWoodford, Neil
dc.contributor.authorFalgenhauer, Linda
dc.contributor.authorChakraborty, Trinad
dc.contributor.authorSamuelsen, Ørjan
dc.contributor.authorSjöström, Karin
dc.contributor.authorJohannesen, Thor B
dc.contributor.authorNg, Kim
dc.contributor.authorNielsen, Jens
dc.contributor.authorEthelberg, Steen
dc.contributor.authorStegger, Marc
dc.contributor.authorHammerum, Anette M.
dc.contributor.authorHasman, Henrik
dc.date.accessioned2019-03-06T12:38:57Z
dc.date.available2019-03-06T12:38:57Z
dc.date.issued2018-07-18
dc.description.abstract<i>Escherichia coli</i> sequence type 410 (ST410) has been reported worldwide as an extraintestinal pathogen associated with resistance to fluoroquinolones, third-generation cephalosporins, and carbapenems. In the present study, we investigated national epidemiology of ST410 <i>E. coli</i> isolates from Danish patients. Furthermore, <i>E. coli</i> ST410 was investigated in a global context to provide further insight into the acquisition of the carbapenemase genes <i>bla</i><sub>OXA-181</sub> and <i>bla</i><sub>NDM-5</sub> of this successful lineage. From 127 whole-genome-sequenced isolates, we reconstructed an evolutionary framework of <i>E. coli</i> ST410 which portrays the antimicrobial-resistant clades B2/H24R, B3/H24Rx, and B4/H24RxC. The B2/H24R and B3/H24Rx clades emerged around 1987, concurrently with the C1/H30R and C2/H30Rx clades in <i>E. coli</i> ST131. B3/H24Rx appears to have evolved by the acquisition of the extended-spectrum β-lactamase (ESBL)-encoding gene <i>bla</i><sub>CTX-M-15</sub> and an IncFII plasmid, encoding IncFIA and IncFIB. Around 2003, the carbapenem-resistant clade B4/H24RxC emerged when ST410 acquired an IncX3 plasmid carrying a <i>bla</i><sub>OXA-181</sub> carbapenemase gene. Around 2014, the clade B4/H24RxC acquired a second carbapenemase gene, <i>bla</i><sub>NDM-5</sub>, on a conserved IncFII plasmid. From an epidemiological investigation of 49 <i>E. coli</i> ST410 isolates from Danish patients, we identified five possible regional outbreaks, of which one outbreak involved nine patients with <i>bla</i><sub>OXA-181</sub>- and <i>bla</i><sub>NDM-5</sub>-carrying B4/H24RxC isolates. The accumulated multidrug resistance in <i>E. coli</i> ST410 over the past two decades, together with its proven potential of transmission between patients, poses a high risk in clinical settings, and thus, <i>E. coli</i> ST410 should be considered a lineage with emerging “high-risk” clones, which should be monitored closely in the future.en_US
dc.description.abstract<b>Importance</b><br>Extraintestinal pathogenic <i>Escherichia coli</i> (ExPEC) is the main cause of urinary tract infections and septicemia. Significant attention has been given to the ExPEC sequence type ST131, which has been categorized as a “high-risk” clone. High-risk clones are globally distributed clones associated with various antimicrobial resistance determinants, ease of transmission, persistence in hosts, and effective transmission between hosts. The high-risk clones have enhanced pathogenicity and cause severe and/or recurrent infections. We show that clones of the E. coli ST410 lineage persist and/or cause recurrent infections in humans, including bloodstream infections. We found evidence of ST410 being a highly resistant globally distributed lineage, capable of patient-to-patient transmission causing hospital outbreaks. Our analysis suggests that the ST410 lineage should be classified with the potential to cause new high-risk clones. Thus, with the clonal expansion over the past decades and increased antimicrobial resistance to last-resort treatment options, ST410 needs to be monitored prospectively.en_US
dc.description.sponsorshipThe Danish Ministry of Health and Prevention The Scandinavian Society for Antimicrobial Chemotherapy Foundationen_US
dc.descriptionSource at <a href=https://doi.org/10.1128/mSphere.00337-18> https://doi.org/10.1128/mSphere.00337-18</a>.en_US
dc.identifier.citationRoer, L., Overballe-Petersen, S., Hansen, F., Schønning, K., Wang, M., Røder, B.L., ... Hasman, H. (2018). <i>Escherichia coli</i> Sequence Type 410 Is Causing New International High-Risk Clones. <i>mSphere, 3</i>(4). https://doi.org/10.1128/mSphere.00337-18en_US
dc.identifier.cristinIDFRIDAID 1679516
dc.identifier.doi10.1128/mSphere.00337-18
dc.identifier.issn2379-5042
dc.identifier.urihttps://hdl.handle.net/10037/14868
dc.language.isoengen_US
dc.publisherAmerican Society for Microbiologyen_US
dc.relation.journalmSphere
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710::Medical microbiology: 715en_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710::Medisinsk mikrobiologi: 715en_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710::Pharmacology: 728en_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710::Farmakologi: 728en_US
dc.subjectBEASTen_US
dc.subjectepidemiologyen_US
dc.subjectEscherichia colien_US
dc.subjectoutbreaken_US
dc.subjectevolutionen_US
dc.subjecthigh-risk cloneen_US
dc.titleEscherichia coli Sequence Type 410 Is Causing New International High-Risk Clonesen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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