Global Distribution of O Serotypes and Antibiotic Resistance in Extraintestinal Pathogenic Escherichia coli Collected From the Blood of Patients With Bacteremia Across Multiple Surveillance Studies.

BACKGROUND

Extraintestinal pathogenic Escherichia coli (ExPEC) is the leading cause of bacteremia worldwide, with older populations having increased risk of invasive bacterial disease. Increasing resistance to first-line antibiotics and emergence of multidrug-resistant (MDR) strains represent major treatment challenges. ExPEC O serotypes are key targets for potential multivalent conjugate vaccine development. Therefore, we evaluated the O serotype distribution and antibiotic resistance profiles of ExPEC strains causing bloodstream infections across 4 regions.

METHODS

Blood culture isolates from patients aged ≥60 years collected during 5 retrospective E. coli surveillance studies in Europe, North America, Asia-Pacific, and South America (2011-2017) were analyzed. Isolates were O serotyped by agglutination; O genotyping was performed for nontypeable isolates. Antimicrobial susceptibility testing was also conducted.

RESULTS

Among 3217 ExPEC blood culture isolates, the most ubiquitous O serotype was O25 (n = 737 [22.9%]), followed by O2, O6, O1, O75, O15, O8, O16, O4, O18, O77 group, O153, O9, O101/O162, O86, and O13 (prevalence of ≥1%). The prevalence of these O serotypes was generally consistent across regions, apart from South America; together, these 16 O serotypes represented 77.6% of all ExPEC bacteremia isolates analyzed. The overall MDR frequency was 10.7%, with limited variation between regions. Within the MDR subset (n = 345), O25 showed a dominant prevalence of 63.2% (n = 218).

CONCLUSIONS

Predominant O serotypes among ExPEC bacteremia isolates are widespread across different regions. O25 was the most prevalent O serotype overall and particularly dominant among MDR isolates. These findings may inform the design of multivalent conjugate vaccines that can target the predominant O serotypes associated with invasive ExPEC disease in older adults.

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

Déclaration de conflit d'intérêts

Potential conflicts of interest. E. W., T. D., B. M., O. G., B. S., T. v. d. H., G. v. G., M. A., J. P., and J. G. are employees of Janssen Pharmaceutical Companies of Johnson & Johnson and potential stockholders of Johnson & Johnson. T. D. reports support for attending meetings/and or travel, stock options, and other financial or nonfinancial interests from Janssen Research & Development. A. L. Z. reports payments from Janssen Pharmaceuticals to Utrecht University. A. L. Z. is an employee of Utrecht University, Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, in Utrecht, the Netherlands, providing services for Janssen Vaccines and Prevention, Leiden, the Netherlands. P. H. was an employee of Janssen Pharmaceuticals at the time of the study, is a potential stockholder of Johnson & Johnson, and reports consulting fees from Johnson & Johnson. O. G. reports Johnson & Johnson stocks in a 401K and personal account. B. M. reports stock or stock options from Janssen Pharmaceuticals, a pharmaceutical company of Johnson & Johnson. B. S. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events as an employee of Johnson & Johnson and stock options from Johnson & Johnson. E. W. reports ownership of Johnson & Johnson stock (options). M. B. acted as a paid consultant for Janssen Pharmaceuticals, Merck, GSK, Pfizer, and Novartis, with payments going to UMC Utrecht and participated on a data safety monitoring board or advisory board for Sanofi, with all payments going to UMC Utrecht. J. P. reports Johnson & Johnson stock. J. G. reports ownership of Johnson & Johnson stock (options). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.