Document Type
Article
Publication Date
7-5-2019
Identifier
DOI: 10.1371/journal.pone.0219352; PMCID: PMC6611611
Abstract
BACKGROUND: Escherichia coli is a major cause of neonatal sepsis. Contemporary antibiotic resistance data and molecular characterization of neonatal E. coli bacteremia isolates in the US are limited.
METHODS: E. coli blood isolates, antibiotic susceptibility data, and clinical characteristics were obtained from prospectively identified newborns from 2006 to 2016. The E. coli isolates were classified using an updated phylogrouping method and multi-locus sequence typing. The presence of several virulence traits was also determined.
RESULTS: Forty-three newborns with E. coli bacteremia were identified. Mean gestational age was 32.3 (SD±5.4) weeks. Median age was 7 days (interquartile range 0-10). Mortality (28%) occurred exclusively in preterm newborns. Resistance to ampicillin was 67%, to gentamicin was 14%, and to ceftriaxone was 2%; one isolate produced extended-spectrum beta lactamases. Phylogroup B2 predominated. Sequence type (ST) 95 and ST131 prevailed; ST1193 emerged recently. All isolates carried fimH, nlpI, and ompA, and 46% carried the K1 capsule. E. coli from newborns with bacteremia diagnosed at≥ 72 hours old. The hek/hra gene was more frequent in isolates from newborns who died than in isolates from survivors.
CONCLUSION: Antibiotic resistance in E. coli was prevalent in this large collection of bacteremia isolates from US newborns. Most strains belonged to distinctive extra-intestinal pathogenic E. coil phylogroups and STs. Further characterization of virulence genes in neonatal E. coli bacteremia strains is needed in larger numbers and in more geographically diverse areas.
Journal Title
PLoS One
Volume
14
Issue
7
First Page
0219352
Last Page
0219352
MeSH Keywords
Anti-Bacterial Agents; Bacteremia; Drug Resistance, Bacterial; Escherichia coli; Escherichia coli Infections; Genotype; Humans; Infant, Newborn; Multilocus Sequence Typing; Phylogeny; United States; Virulence
Keywords
Anti-Bacterial Agents; Bacteremia; Drug Resistance, Bacterial; Escherichia coli; Escherichia coli Infections; Genotype; Humans; Infant, Newborn; Multilocus Sequence Typing; Phylogeny; United States; Virulence
Recommended Citation
Cole BK, Ilikj M, McCloskey CB, Chavez-Bueno S. Antibiotic resistance and molecular characterization of bacteremia Escherichia coli isolates from newborns in the United States. PLoS One. 2019;14(7):e0219352. Published 2019 Jul 5. doi:10.1371/journal.pone.0219352
Included in
Infectious Disease Commons, Pathology Commons, Pediatrics Commons
Comments
Grant support
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Publisher's Link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0219352