Institute for Molecular Bioscience (IMB), The University of Queensland, Brisbane, Australia; School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia; Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
Institute for Molecular Bioscience (IMB), The University of Queensland, Brisbane, Australia; School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia; Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
Steven J Hancock
School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia; Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
Kate M Peters
Institute for Molecular Bioscience (IMB), The University of Queensland, Brisbane, Australia; School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia; Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
Laura Alvarez-Fraga
School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia; Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
Brian M Forde
Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia; University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia
Stacey B Andersen
Genome Innovation Hub, The University of Queensland, Brisbane, Australia
Thyl Miliya
Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia; Pathology Queensland, Queensland Health, Brisbane, Australia
Scott A Beatson
School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia; Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
Sanmarie Schlebusch
University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia; Pathology Queensland, Queensland Health, Brisbane, Australia; Q-PHIRE Genomics and Public Health Microbiology, Forensic and Scientific Services, Coopers Plains, Brisbane, Australia
Haakon Bergh
Pathology Queensland, Queensland Health, Brisbane, Australia
Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
Annelie Brauner
Department of Microbiology, Tumor and Cell Biology, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia; University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia; Infection Management Prevention Service, Queensland Children's Hospital, Brisbane, Australia
Institute for Molecular Bioscience (IMB), The University of Queensland, Brisbane, Australia; School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia; Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
Neonatal meningitis is a devastating disease associated with high mortality and neurological sequelae. Escherichia coli is the second most common cause of neonatal meningitis in full-term infants (herein NMEC) and the most common cause of meningitis in preterm neonates. Here, we investigated the genomic relatedness of a collection of 58 NMEC isolates spanning 1974–2020 and isolated from seven different geographic regions. We show NMEC are comprised of diverse sequence types (STs), with ST95 (34.5%) and ST1193 (15.5%) the most common. No single virulence gene profile was conserved in all isolates; however, genes encoding fimbrial adhesins, iron acquisition systems, the K1 capsule, and O antigen types O18, O75, and O2 were most prevalent. Antibiotic resistance genes occurred infrequently in our collection. We also monitored the infection dynamics in three patients that suffered recrudescent invasive infection caused by the original infecting isolate despite appropriate antibiotic treatment based on antibiogram profile and resistance genotype. These patients exhibited severe gut dysbiosis. In one patient, the causative NMEC isolate was also detected in the fecal flora at the time of the second infection episode and after treatment. Thus, although antibiotics are the standard of care for NMEC treatment, our data suggest that failure to eliminate the causative NMEC that resides intestinally can lead to the existence of a refractory reservoir that may seed recrudescent infection.
