Distribution of virulence genes and antimicrobial resistance of Escherichia coli isolated from hospitalized neonates: A multi-center study across China
Yuting Guo,
Ruiqi Xiao,
Jinxing Feng,
Xiaoyun Wang,
Jidong Lai,
Wenqing Kang,
Yangfang Li,
Xueping Zhu,
Tongzhen Ji,
Xuerong Huang,
Dan Pang,
Yanbin An,
Lihui Meng,
Yajuan Wang
Affiliations
Yuting Guo
Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Department of Neonatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
Ruiqi Xiao
Capital Institute of Pediatrics, Beijing, China
Jinxing Feng
Department of Neonatology, Shenzhen Children's Hospital, Shenzhen, China
Xiaoyun Wang
Inner Mongolia Maternity and Child Health Care Hospital, Inner Mongolia, China
Jidong Lai
Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
Wenqing Kang
Neonatal Intensive Care Unit, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, Henan, China
Yangfang Li
Department of Neonatology, Children's Hospital of Kunming, Kunming, Yunnan, China
Xueping Zhu
Department of Neonatology, Children's Hospital of Soochow University, Suzhou City, Jiangsu Province, China
Tongzhen Ji
Clinical Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
Xuerong Huang
Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
Dan Pang
Clinical Laboratory,Inner Mongolia Maternity and Child Health Care Hospital,Inner Mongolia, China
Yanbin An
Inner Mongolia Maternity and Child Health Care Hospital, Inner Mongolia, China
Lihui Meng
Department of Infectious Diseases, Children's Hospital, Capital Institute of Pediatrics, 2# Yabao Road, Chaoyang District, Beijing 100020, China; Corresponding author.
Yajuan Wang
Department of Neonatology, Children's Hospital, Capital Institute of Pediatrics, 2# Yabao Road, Chaoyang District, Beijing 100020, China; Corresponding author. Children's Hospital, Capital Institute of Pediatrics,2# Yabao Road, Chaoyang District, Beijing, 100020, China.
Background: Escherichia coli is the most common gram-negative pathogen to cause neonatal infections. Contemporary virulence characterization and antimicrobial resistance (AMR) data of neonatal E. coli isolates in China are limited. Methods: A total of 159 E. coli strains isolated from neonates were collected and classified into invasive and non-invasive infection groups, according to their site of origin. The presence of virulence genes was determined using polymerase chain reaction (PCR). All the strains were subjected to antimicrobial susceptibility testing using the broth dilution method. Results: The top three virulence genes with the highest detection rates were fimH (90.6 %), iutA (88.7 %), and kspMT II (88.1 %). The prevalences of fyuA (p = 0.023), kpsMT K1 (p = 0.019), ibeA (p < 0.001), and iroN (p = 0.027) were significantly higher in the invasive infection group than in the non-invasive infection group. Resistance to ceftazixime, sulfamethoxazole/trimethoprim, and ciprofloxacin was 75.5 %, 65.4 %, and 48.4 %, respectively. Lower rates of resistance to ceftazidime (p = 0.022), cefepime (p = 0.005), ticarcillin/clavulanic acid (p = 0.020) and aztreonam (p = 0.001) were observed in the invasive infection group compared to the non-invasive infection group. The number of virulence genes carried by E. coli was positively correlated with the number of antibiotics to which the isolates were resistant (r = 0.71, p = 0.016), and a specific virulence gene was associated with resistance to various species of antibiotics. Conclusions: Neonatal E. coli isolates carried multiple virulence genes and were highly resistant to antibiotics. Further studies are needed to understand the molecular mechanisms underlying the association between virulence and AMR.
