Genomic Characterization and Antimicrobial Resistance of ESBL-Producing, Escherichia coli Isolates in Suzhou, China
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".