AUTHOR=Sepp Epp , Andreson Reidar , Balode Arta , Bilozor Anastasia , Brauer Age , Egorova Svetlana , Huik Kristi , Ivanova Marina , Kaftyreva Lidia , Kõljalg Siiri , Kõressaar Triinu , Makarova Maria , Miciuleviciene Jolanta , Pai Kristiine , Remm Maido , Rööp Tiiu , Naaber Paul 

TITLE=Phenotypic and Molecular Epidemiology of ESBL-, AmpC-, and Carbapenemase-Producing Escherichia coli in Northern and Eastern Europe

JOURNAL=Frontiers in Microbiology

VOLUME=10

YEAR=2019

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2019.02465

DOI=10.3389/fmicb.2019.02465

ISSN=1664-302X

ABSTRACT=<p>Extended-spectrum beta-lactamases (ESBL) and AmpC producing-<italic>Escherichia coli</italic> have spread worldwide, but data about ESBL-producing-<italic>E. coli</italic> in the Northern and Eastern regions of Europe is scant. The aim of this study has been to describe the phenotypical and molecular epidemiology of different ESBL/AmpC/Carbapenemases genes in <italic>E. coli</italic> strains isolated from the Baltic States (Estonia, Latvia, and Lithuania), Norway and St. Petersburg (Russia), and to determine the predominant multilocus sequence type and single nucleotide polymorphisms diversity of <italic>E. coli</italic> isolates deduced by whole genome sequencing (WGS). A total of 10,780 clinical <italic>E. coli</italic> strains were screened for reduced sensitivity to third-generation cephalosporins. They were collected from 21 hospitals located in Estonia, Latvia, Lithuania, Norway and St. Petersburg during a 5 month period in 2012. The overall prevalence of ESBL/AmpC strains was 4.7% by phenotypical test and 3.9% by sequencing. We found more strains with the ESBL/AmpC phenotype and genotype in St. Petersburg and Latvia than other countries. Of phenotypic <italic>E. coli</italic> strains, 85% contained confirmed ESBL genes (including <italic>bla</italic><sub>CTX–M</sub>, <italic>bla</italic><sub>TEM–</sub><sub>29</sub>, <italic>bla</italic><sub>TEM–</sub><sub>71</sub>), AmpC genes (<italic>bla</italic><sub>CMY–</sub><sub>59</sub>, <italic>bla</italic><sub>ACT–</sub><sub>12</sub><sub>/</sub><sub>–</sub><sub>15</sub><sub>/</sub><sub>–</sub><sub>20</sub>, <italic>bla</italic><sub>ESC–</sub><sub>6</sub>, <italic>bla</italic><sub>FEC–</sub><sub>1</sub>, <italic>bla</italic><sub>DHA–</sub><sub>1</sub>), or carbapenemase genes (<italic>bla</italic><sub>NDM–</sub><sub>1</sub>). <italic>bla</italic><sub>CTX–M–</sub><sub>1</sub>, <italic>bla</italic><sub>CTX–M</sub><sub>–</sub><sub>14</sub> and <italic>bla</italic><sub>CTX–M–</sub><sub>15</sub> were found in all countries, but <italic>bla</italic><sub>CTX–M–</sub><sub>15</sub> prevalence was higher in Latvia than in St. Petersburg (Russia), Estonia, Norway and Lithuania. The dominating AmpC genes were <italic>bla</italic><sub>CMY–</sub><sub>59</sub> in the Baltic States and Norway, and <italic>bla</italic><sub>DHA–</sub><sub>1</sub> in St. Petersburg. <italic>E. coli</italic> strains belonged to 83 different sequence types, of which the most prevalent was ST131 (40%). In conclusion, we generally found low ESBL/AmpC/Carbapenemase prevalence in <italic>E. coli</italic> strains isolated in Northern/Eastern Europe. However, several inter-country differences in distribution of particular genes and multilocus sequence types were found.</p>