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Evolutionary history of the global emergence of the Escherichia coli epidemic clone ST131

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Stoesser, Nicole, Sheppard, Anna E., Pankhurst, Louise, De Maio, Nicola, Moore, Catrin E., Sebra, Robert, Turner, Paul, Anson, Luke W., Kasarskis, Andrew, Batty, Elizabeth M. et al.
(2016) Evolutionary history of the global emergence of the Escherichia coli epidemic clone ST131. mBio, 7 (2). doi:10.1128/mBio.02162-15

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Official URL: http://dx.doi.org/10.1128/mBio.02162-15

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Abstract

Escherichia coli sequence type 131 (ST131) has emerged globally as the most predominant extraintestinal pathogenic lineage within this clinically important species, and its association with fluoroquinolone and extended-spectrum cephalosporin resistance impacts significantly on treatment. The evolutionary histories of this lineage, and of important antimicrobial resistance elements within it, remain unclearly defined. This study of the largest worldwide collection (n = 215) of sequenced ST131 E. coli isolates to date demonstrates that the clonal expansion of two previously recognized antimicrobial-resistant clades, C1/H30R and C2/H30Rx, started around 25 years ago, consistent with the widespread introduction of fluoroquinolones and extended-spectrum cephalosporins in clinical medicine. These two clades appear to have emerged in the United States, with the expansion of the C2/H30Rx clade driven by the acquisition of a blaCTX-M-15-containing IncFII-like plasmid that has subsequently undergone extensive rearrangement. Several other evolutionary processes influencing the trajectory of this drug-resistant lineage are described, including sporadic acquisitions of CTX-M resistance plasmids and chromosomal integration of blaCTX-M within subclusters followed by vertical evolution. These processes are also occurring for another family of CTX-M gene variants more recently observed among ST131, the blaCTX-M-14/14-like group. The complexity of the evolutionary history of ST131 has important implications for antimicrobial resistance surveillance, epidemiological analysis, and control of emerging clinical lineages of E. coli. These data also highlight the global imperative to reduce specific antibiotic selection pressures and demonstrate the important and varied roles played by plasmids and other mobile genetic elements in the perpetuation of antimicrobial resistance within lineages.

Item Type: Journal Article
Divisions: Faculty of Science > Life Sciences (2010- )
Journal or Publication Title: mBio
Publisher: American Society for Microbiology
ISSN: 2150-7511
Official Date: 22 March 2016
Dates:
DateEvent
22 March 2016Available
25 February 2016Accepted
Volume: 7
Number: 2
DOI: 10.1128/mBio.02162-15
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access

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