Genomic epidemiology reveals geographical clustering of multidrug-resistant Escherichia coli ST131 associated with bacteraemia in Wales

Rhys T. White, Matthew J. Bull, Clare R. Barker, Julie M. Arnott, Mandy Wootton, Lim S. Jones, Robin A. Howe, Mari Morgan, Melinda M. Ashcroft, Brian M. Forde, Thomas R. Connor () and Scott A. Beatson ()
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Rhys T. White: The University of Queensland
Matthew J. Bull: Cardiff University
Clare R. Barker: Cardiff University
Julie M. Arnott: Public Health Wales, 2 Capital Quarter
Mandy Wootton: University Hospital of Wales
Lim S. Jones: University Hospital of Wales
Robin A. Howe: University Hospital of Wales
Mari Morgan: Public Health Wales, 2 Capital Quarter
Melinda M. Ashcroft: The University of Melbourne at The Peter Doherty Institute for Infection and Immunity
Brian M. Forde: The University of Queensland
Thomas R. Connor: Cardiff University
Scott A. Beatson: The University of Queensland

Nature Communications, 2024, vol. 15, issue 1, 1-10

Abstract: Abstract Antibiotic resistance is a significant global public health concern. Uropathogenic Escherichia coli sequence type (ST)131, a widely prevalent multidrug-resistant clone, is frequently associated with bacteraemia. This study investigates third-generation cephalosporin resistance in bloodstream infections caused by E. coli ST131. From 2013-2014 blood culture surveillance in Wales, 142 E. coli ST131 genomes were studied alongside global data. All three major ST131 clades were represented across Wales, with clade C/H30 predominant (n = 102/142, 71.8%). Consistent with global findings, Welsh strains of clade C/H30 contain β-lactamase genes from the blaCTX-M-1 group (n = 65/102, 63.7%), which confer resistance to third-generation cephalosporins. Most Welsh clade C/H30 genomes belonged to sub-clade C2/H30Rx (58.3%). A Wales-specific sub-lineage, named GB-WLS.C2, diverged around 1996-2000. An introduction to North Wales around 2002 led to a localised cluster by 2009, depicting limited genomic diversity within North Wales. This investigation emphasises the value of genomic epidemiology, allowing the detection of genetically similar strains in local areas, enabling targeted and timely public health interventions.

Date: 2024
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DOI: 10.1038/s41467-024-45608-1

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