Population dynamics of an Escherichia coli ST131 lineage during recurrent urinary tract infection

Brian M. Forde, Leah W. Roberts, Minh-Duy Phan, Kate M. Peters, Brittany A. Fleming, Colin W. Russell, Sara M. Lenherr, Jeremy B. Myers, Adam P. Barker, Mark A. Fisher, Teik-Min Chong, Wai-Fong Yin, Kok-Gan Chan, Mark A. Schembri (), Matthew A. Mulvey () and Scott A. Beatson ()
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Brian M. Forde: The University of Queensland
Leah W. Roberts: The University of Queensland
Minh-Duy Phan: The University of Queensland
Kate M. Peters: The University of Queensland
Brittany A. Fleming: University of Utah School of Medicine
Colin W. Russell: University of Utah School of Medicine
Sara M. Lenherr: University of Utah
Jeremy B. Myers: University of Utah
Adam P. Barker: University of Utah
Mark A. Fisher: University of Utah
Teik-Min Chong: University of Malaya
Wai-Fong Yin: University of Malaya
Kok-Gan Chan: University of Malaya
Mark A. Schembri: The University of Queensland
Matthew A. Mulvey: University of Utah School of Medicine
Scott A. Beatson: The University of Queensland

Nature Communications, 2019, vol. 10, issue 1, 1-10

Abstract: Abstract Recurrent urinary tract infections (rUTIs) are extremely common, with ~ 25% of all women experiencing a recurrence within 1 year of their original infection. Escherichia coli ST131 is a globally dominant multidrug resistant clone associated with high rates of rUTI. Here, we show the dynamics of an ST131 population over a 5-year period from one elderly woman with rUTI since the 1970s. Using whole genome sequencing, we identify an indigenous clonal lineage (P1A) linked to rUTI and persistence in the fecal flora, providing compelling evidence of an intestinal reservoir of rUTI. We also show that the P1A lineage possesses substantial plasmid diversity, resulting in the coexistence of antibiotic resistant and sensitive intestinal isolates despite frequent treatment. Our longitudinal study provides a unique comprehensive genomic analysis of a clonal lineage within a single individual and suggests a population-wide resistance mechanism enabling rapid adaptation to fluctuating antibiotic exposure.

Date: 2019
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DOI: 10.1038/s41467-019-11571-5

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