Centre for Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China.
Institute of Microbiology and Infection, College of Medical and Dental Science, University of Birmingham, Birmingham B15 2TT, UK.
J Antimicrob Chemother. 2018 Sep 1;73(9):2340-2346. doi: 10.1093/jac/dky210.
The increase in infections as a result of MDR strains of Escherichia coli is a global health crisis. The emergence of globally disseminated lineages of E. coli carrying ESBL genes has been well characterized. An increase in strains producing carbapenemase enzymes and mobile colistin resistance is now being reported, but to date there is little genomic characterization of such strains.
Routine screening of patients within an ICU of West China Hospital identified a number of E. coli carrying the blaNDM-5 carbapenemase gene, found to be two distinct clones, E. coli ST167 and ST617.
Interrogation of publicly available data shows isolation of ESBL and carbapenem-resistant strains of both lineages from clinical cases across the world. Further analysis of a large collection of publicly available genomes shows that ST167 and ST617 have emerged in distinct patterns from the ST10 clonal complex of E. coli, but share evolutionary events involving switches in LPS genetics, intergenic regions and anaerobic metabolism loci.
The identification of these lineages of E. coli and their shared genetic traits suggest there may be evolutionary events that underpin the emergence of carbapenem resistance plasmid carriage in E. coli.
由于耐多药大肠杆菌（MDR）菌株引起的感染增加是全球健康危机。具有 ESBL 基因的大肠杆菌全球传播谱系的出现已经得到很好的描述。现在，产碳青霉烯酶和移动多粘菌素耐药性的菌株数量不断增加，但迄今为止，对这些菌株的基因组特征描述很少。
对华西医院 ICU 内的患者进行常规筛查，发现了一些携带 blaNDM-5 碳青霉烯酶基因的大肠杆菌，这些基因被发现是两种不同的克隆，大肠杆菌 ST167 和 ST617。
对公开可用数据的查询显示，来自世界各地临床病例的 ESBL 和耐碳青霉烯类菌株都分离出了这两种谱系。对大量公开基因组的进一步分析表明，ST167 和 ST617 与大肠杆菌 ST10 克隆复合体的出现模式明显不同，但它们具有涉及 LPS 遗传学、基因间区和厌氧代谢基因座转换的共同进化事件。
这些大肠杆菌谱系的鉴定及其共同的遗传特征表明，可能存在一些进化事件，这些事件是大肠杆菌耐碳青霉烯类质粒携带的出现的基础。
