Virulence Potential of ESBL-Producing Escherichia coli Isolated during the Perinatal Period

Abstract

Objective

The aim of the study was to investigate the virulence factors in Escherichia coli producing extended-spectrum β-lactamase (ESBL) derived from the perinatal fecal colonization flora of mothers and their newborns in a Chinese obstetric ward.

Study Design

Rectal swabs were obtained from mothers prenatally and from their newborns postnatally, and analyzed for ESBL-producing Escherichia coli. The isolates were then whole-genome sequenced.

Results

Maternal and neonatal colonization by ESBL-producing E. coli in a Chinese obstetric ward was 18% (31/177) and 5% (9/170), respectively. Fecal ESBL-producing isolates exhibited a significantly lower frequency of virulence factors compared with invasive E. coli.

Conclusion

Providing balanced information on screening results is essential, along with conducting a risk assessment for antibiotic treatment strategies.

Key Points

• High ESBL E. coli colonization rates in mothers and neonates perinatally

• Fecal ESBL-producing E. coli showed fewer virulence traits.

• ESBL-producing E. coli knowledge may prompt antibiotic overuse.

Keywords

Escherichia coli - fecal carriage - virulence factors - extended-spectrum β-lactamase - ESBL

• References

• 1 Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med 2018; 6 (03) 223-230
• 2 Jiménez-Rojas V, Villanueva-García D, Miranda-Vega AL. et al. Gut colonization and subsequent infection of neonates caused by extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae . Front Cell Infect Microbiol 2024; 13: 1322874
• 3 Bezabih YM, Sabiiti W, Alamneh E. et al. The global prevalence and trend of human intestinal carriage of ESBL-producing Escherichia coli in the community. J Antimicrob Chemother 2021; 76 (01) 22-29
• 4 Heydecke A, Myrelid Å, Normann E, Gullsby K, Tano E, Sütterlin S. Whole genome sequencing of invasive neonatal Escherichia coli from Uppsala County, Sweden. J Infect Dis 2024; jiae309
• 5 Rottier WC, Bamberg YRP, Dorigo-Zetsma JW, van der Linden PD, Ammerlaan HSM, Bonten MJM. Predictive value of prior colonization and antibiotic use for third-generation cephalosporin-resistant Enterobacteriaceae bacteremia in patients with sepsis. Clin Infect Dis 2015; 60 (11) 1622-1630
• 6 Sanidad KZ, Zeng MY. Neonatal gut microbiome and immunity. Curr Opin Microbiol 2020; 56: 30-37
• 7 Nowrouzian FL, Wold AE, Adlerberth I. Escherichia coli strains belonging to phylogenetic group B2 have superior capacity to persist in the intestinal microflora of infants. J Infect Dis 2005; 191 (07) 1078-1083
• 8 Denkel LA, Gastmeier P, Piening B. To screen or not to screen mothers of preterm infants for extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). J Perinatol Off J Calif Perinat Assoc 2015; 35 (11) 893-894
• 9 Prevel R, Boyer A, M'Zali F. et al. Is systematic fecal carriage screening of extended-spectrum beta-lactamase-producing Enterobacteriaceae still useful in intensive care unit: a systematic review. Crit Care 2019; 23 (01) 170
• 10 Turbett SE, Mansour MK. Editorial Commentary: Fecal ESBL screening: are we ready for this information?. Clin Infect Dis 2016; 63 (03) 319-321
• 11 Wiklund S, Örtqvist Å, Berlin A, Stamm C, Broliden K. Experiences and consequences of living with extended-spectrum β-lactamase-producing bacteria: a qualitative study. Am J Infect Control 2018; 46 (12) 1394-1399