Emergence of Enteroaggregative Escherichia coli within the ST131 Lineage as a Cause of Extraintestinal Infections

Author:

Boll Erik J.1,Overballe-Petersen Søren1,Hasman Henrik1,Roer Louise1,Ng Kim1,Scheutz Flemming1,Hammerum Anette M.1,Dungu Arnold2,Hansen Frank1,Johannesen Thor B.1,Johnson Abigail3,Nair Divek T.4,Lilje Berit1,Hansen Dennis S.2,Krogfelt Karen A.1ORCID,Johnson Timothy J.3,Price Lance B.56ORCID,Johnson James R.78,Struve Carsten1,Olesen Bente2,Stegger Marc16ORCID

Affiliation:

1. Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark

2. Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark

3. Department of Veterinary and Biomedical Sciences, University of Minnesota, Saint Paul, Minnesota, USA

4. Department of Animal Sciences, University of Minnesota, Saint Paul, Minnesota, USA

5. Division of Pathogen Genomics, Translational Genomics Research Institute, Flagstaff, Arizona, USA

6. Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA

7. VA Medical Center, Minneapolis, Minnesota, USA

8. University of Minnesota, Minneapolis, Minnesota, USA

Abstract

E. coli ST131 is an important extraintestinal pathogenic lineage. A signature characteristic of ST131 is its ability to asymptomatically colonize the gastrointestinal tract and then opportunistically cause extraintestinal infections, such as cystitis, pyelonephritis, and urosepsis. In this study, we identified an ST131 H 27 sublineage that has acquired the enteroaggregative diarrheagenic phenotype, spread across multiple continents, and caused multiple outbreaks of community-acquired ESBL-associated bloodstream infections in Denmark. The strain’s ability to both cause diarrhea and innocuously colonize the human gastrointestinal tract may facilitate its dissemination and establishment in the community.

Funder

Danish Council for Research

Danish Ministry of Health

Office of Research and Development

Publisher

American Society for Microbiology

Subject

Virology,Microbiology

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