AUTHOR=Sanz María Belén , De Belder Denise , de Mendieta JM , Faccone Diego , Poklepovich Tomás , Lucero Celeste , Rapoport Melina , Campos Josefina , Tuduri Ezequiel , Saavedra Mathew O. , Van der Ploeg Claudia , Rogé Ariel ,  Carbapenemases-ExPEC Group , Pasteran Fernando , Corso Alejandra , Rosato Adriana E. , Gomez Sonia A. , Piersigulli A. , Aleman H. , Veliz O. , Giudice N. , Sujemecki A. , Cerda N. , Bardi Leticia , Rodriguez A. , Gral H. , Badi M. , de Agudos H. Gral , Flabiani M. , Togneri A. , Andrés P. , Biondi E. , Rocallo M. , Gerardo M. , Ortiz S. , Heller H. , Sauer H. , Carol Rey M. , Naval H. , Pidone J. C. , Bongiovanni M. E. , Vilaro M. , Santojanni H. , Alfonodo C. , Bartoli M. Z. , Vacaflor L. , Gonzalez L. , Visus M. A. , Errecalde L. , Baudaz B. , Tula C. , de Paulis A. , Littvik A. , Nuñez M. R. , Mariñansky A. L. , Romeo A. M. , Di Bella A. , Archuby D. , Littvik A. , Bottinelli L. , Zarate S. , Reynaldi M. , Manganello S. 

TITLE=Carbapenemase-Producing Extraintestinal Pathogenic Escherichia coli From Argentina: Clonal Diversity and Predominance of Hyperepidemic Clones CC10 and CC131

JOURNAL=Frontiers in Microbiology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2022.830209

DOI=10.3389/fmicb.2022.830209

ISSN=1664-302X

ABSTRACT=<p>Extraintestinal pathogenic <italic>Escherichia coli</italic> (ExPEC) causes infections outside the intestine. Particular ExPEC clones, such as clonal complex (CC)/sequence type (ST)131, have been known to sequentially accumulate antimicrobial resistance that starts with chromosomal mutations against fluoroquinolones, followed with the acquisition of <italic>bla</italic><sub>CTX–M–15</sub> and, more recently, carbapenemases. Here we aimed to investigate the distribution of global epidemic clones of carbapenemase-producing ExPEC from Argentina in representative clinical isolates recovered between July 2008 and March 2017. Carbapenemase-producing ExPEC (<italic>n</italic> = 160) were referred to the Argentinean reference laboratory. Of these, 71 were selected for genome sequencing. Phenotypic and microbiological studies confirmed the presence of carbapenemases confirmed as KPC-2 (<italic>n</italic> = 52), NDM-1 (<italic>n</italic> = 16), IMP-8 (<italic>n</italic> = 2), and VIM-1 (<italic>n</italic> = 1) producers. The isolates had been recovered mainly from urine, blood, and abdominal fluids among others, and some were from screening samples. After analyzing the virulence gene content, 76% of the isolates were considered ExPEC, although non-ExPEC isolates were also obtained from extraintestinal sites. Pan-genome phylogeny and clonal analysis showed great clonal diversity, although the first phylogroup in abundance was phylogroup A, harboring CC10 isolates, followed by phylogroup B2 with CC/ST131, mostly H30Rx, the subclone co-producing CTX-M-15. Phylogroups D, B1, C, F, and E were also detected with fewer strains. CC10 and CC/ST131 were found throughout the country. In addition, CC10 nucleated most metalloenzymes, such as NDM-1. Other relevant international clones were identified, such as CC/ST38, CC155, CC14/ST1193, and CC23. Two isolates co-produced KPC-2 and OXA-163 or OXA-439, a point mutation variant of OXA-163, and three isolates co-produced MCR-1 among other resistance genes. To conclude, in this work, we described the molecular epidemiology of carbapenemase-producing ExPEC in Argentina. Further studies are necessary to determine the plasmid families disseminating carbapenemases in ExPEC in this region.</p>