Genomic Characterization and Antimicrobial Resistance of ESBL-Producing, Escherichia coli Isolates in Suzhou, China
Why this work is in the frame
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Bibliographic record
Abstract
Background: The prevalence of third-generation cephalosporin-resistant and extended-spectrum beta-lactamases (ESBL) producing Escherichia coli poses a significant global public health concern due to their resistance to multiple antibiotics; however, their prevalence and epidemiological patterns in China are not very well investigated. Objective: This study aimed to investigate the molecular epidemiology, and antimicrobial susceptibility of ESBL-producing E. coli among clinical isolates in China. Methods: Phenotypic ESBL-producing E. coli isolates were collected from in-patients at a non-tertiary hospital in Suzhou from 2018.06.01 − 2019.11.30. All isolates were identified and analyzed by conventional microbiological methods, and antimicrobial susceptibility testing was determined. Genes associated with resistance to β -lactamases, fluoroquinolone, aminoglycosides, sulfonamides, sequence types (STs), and genetic relationship were characterized through whole-genome sequencing (WGS) data. Results: Eighty-six isolates were collected and sequenced, and genomic analysis identified twenty-five different sequence types (STs). The most prevalent STs were ST131 (n=22, 25.6%), ST1193 (n=16, 18.6%), ST38 (n=9, 10.5%) and ST167 (n=6, 7.0%). bla CTX-M genotypes were the most dominant, comprising a variety of subtypes (eg, bla CTX-M-14, bla CTX-M-15, bla CTX-M-27, bla CTX-M-55) and bla TEM-type among ESBL-producing E. coli in our study. All cases of co-carriage of β -lactamase genes showed a strong link to amoxicillin/sulbactam resistance, while the co-carriage of bla CTX-M-15/TEM-1B or bla CTX-M-15/OXA-1 were strongly linked to resistance against cefepime, ceftazidime, and aztreonam. In addition, genes associated with resistance to fluoroquinolone, aminoglycosides, and sulfonamides were also detected. Conclusion: Our findings highlighted the prevalence of globally circulating ESBL-producing E. coli clones, such as ST131 and ST1193, in Suzhou, China. These clones and sublineages are also resistant to quinolones. No predominant bla CTX-M subtypes were detected, while the coexistence of different ESBL types was strongly linked to resistance to amoxicillin/sulbactam, cefepime, ceftazidime, and aztreonam, suggesting the widespread circulation of diverse bla CTX-M genes within the Suzhou community. In clinical cases of ESBL resistance, carbapenem therapy is recommended as most (> 90%) isolates were susceptible. Keywords: antimicrobial resistance, Escherichia coli , extended spectrum β -lactamase, whole-genome sequencing
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it