WHO Critical Priority Escherichia coli as One Health Challenge for a Post-Pandemic Scenario: Genomic Surveillance and Analysis of Current Trends in Brazil

Microbiology Spectrum

Marcelo Pilonetto¹  Albalúcia C. Carvalho²  Fernanda Esposito³  Herrison Fontana³  Elder Sano⁴  Louise Cerdeira⁴  Brenda Cardoso⁴  Adriana Cardenas-Arias⁴  Bruna Fuga⁴  Quézia Moura⁴  Nilton Lincopan⁴  Ângela Patrícia Santana⁵  Joice N. Reis⁶  Marcia Maria C. de Morais⁷  Thaís C. M. Sincero⁸  Aloysio M. F. Cerqueira⁹  Rosineide M. Ribas^1,10  Ana Judith P. G. Quaresma^1,11  Raquel R. Bonelli^1,12  Eliana Carolina Vespero^1,13  Fábio P. Sellera^1,14  Maria Cristina B. Tognim^1,15 

[1] Central Laboratory of the State of Paraná-LACEN, São Jose dos Pinhais, Brazil;Clinical Laboratory, Federal University of Paraiba, João Pessoa, Paraíba, Brazil;Department of Clinical Analysis, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil;Department of Microbiology, Instituto de Ciências Biomédicas, University of São Paulo, São Paulo, Brazil;Faculty of Agronomy and Veterinary Medicine, University of Brasília, Brasília, Brazil;Faculty of Pharmacy, Federal University of Bahia, Salvador, Brazil;Institute of Biological Sciences, University of Pernambuco, Recife, Brazil;Laboratory of Applied Molecular Microbiology, Department of Clinical Analysis, Federal University of Santa Catarina, Florianópolis, Brazil;Laboratory of Enteropathogens, Veterinary and Food Microbiology, Biomedical Institute, Fluminense Federal University, Niterói, Brazil;Laboratory of Molecular Microbiology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil;Laboratory of Special Pathogen Infections, Bacteriology and Mycology, Evandro Chagas Institute, Ananindeua, Brazil;Medical Microbiology Research Laboratory, Paulo de Góes Institute of Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;Microbiology Laboratory of the University Hospital of Londrina, State University of Londrina, Lonrina, Brazil;One Health Brazilian Resistance Project (OneBR), São Paulo, Brazil;School of Pharmacy, State University of Maringá, Maringá, Brazil;

关键词: Enterobacterales;    resistome;    virulome;    high-risk clones;    One Health;    multidrug resistance;   

DOI  :  10.1128/spectrum.01256-21

来源: DOAJ

【 摘 要 】

ABSTRACT The dissemination of carbapenem-resistant and third generation cephalosporin-resistant pathogens is a critical issue that is no longer restricted to hospital settings. The rapid spread of critical priority pathogens in Brazil is notably worrying, considering its continental dimension, the diversity of international trade, livestock production, and human travel. We conducted a nationwide genomic investigation under a One Health perspective that included Escherichia coli strains isolated from humans and nonhuman sources, over 45 years (1974–2019). One hundred sixty-seven genomes were analyzed extracting clinically relevant information (i.e., resistome, virulome, mobilome, sequence types [STs], and phylogenomic). The endemic status of extended-spectrum β-lactamase (ESBL)-positive strains carrying a wide diversity of blaCTX-M variants, and the growing number of colistin-resistant isolates carrying mcr-type genes was associated with the successful expansion of international ST10, ST38, ST115, ST131, ST354, ST410, ST648, ST517, and ST711 clones; phylogenetically related and shared between human and nonhuman hosts, and polluted aquatic environments. Otherwise, carbapenem-resistant ST48, ST90, ST155, ST167, ST224, ST349, ST457, ST648, ST707, ST744, ST774, and ST2509 clones from human host harbored blaKPC-2 and blaNDM-1 genes. A broad resistome to other clinically relevant antibiotics, hazardous heavy metals, disinfectants, and pesticides was further predicted. Wide virulome associated with invasion/adherence, exotoxin and siderophore production was related to phylogroup B2. The convergence of wide resistome and virulome has contributed to the persistence and rapid spread of international high-risk clones of critical priority E. coli at the human-animal-environmental interface, which must be considered a One Health challenge for a post-pandemic scenario. IMPORTANCE A One Health approach for antimicrobial resistance must integrate whole-genome sequencing surveillance data of critical priority pathogens from human, animal and environmental sources to track hot spots and routes of transmission and developing effective prevention and control strategies. As part of the Grand Challenges Explorations: New Approaches to Characterize the Global Burden of Antimicrobial Resistance Program, we present genomic data of WHO critical priority carbapenemase-resistant, ESBL-producing, and/or colistin-resistant Escherichia coli strains isolated from humans and nonhuman sources in Brazil, a country with continental proportions and high levels of antimicrobial resistance. The present study provided evidence of epidemiological and clinical interest, highlighting that the convergence of wide virulome and resistome has contributed to the persistence and rapid spread of international high-risk clones of E. coli at the human-animal-environmental interface, which must be considered a One Health threat that requires coordinated actions to reduce its incidence in humans and nonhuman hosts.

【 授权许可】

Unknown