Prevalence of ST1193 clone and Incl1/ST16 plasmid in E-coli isolates carrying blaCTX-M-55 gene from urinary tract infections patients in China

To study molecular epidemiology of CTX-M-55-carrying Escherichia coli isolates from urinary tract infections (UTIs) in China. 111 bla(CTX-M-55)-positive E. coli isolates from UTIs patients in China were studied. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were used to analyze the homologies among the strains. Conjugation experiments, S1nuclease PFGE and PCR analysis were performed to characterize plasmids harboring bla(CTX-M-55) and their genetic environment. 111 isolates were clustered into 86 individual pulsotypes and three clusters by PFGE. Fifty-five (49.5%) of the isolates belonged to 8 STs. Most of the ST1193 isolates belonged to one PFGE cluster. Transconjugants (n = 45) derived from randomly selected bla(CTX-M-55) donors (n = 58), were found to contain a single 90-kb conjugative plasmid, which mainly belonged to the Incl1 groups (34, 76%). Among the Incl1 plasmids, the bla(CTX-M-55)/Incl1/ST16 predominated (23/34, 68%). The bla(TEM-1) and aac (3')-II genes were frequently detected on the Incl1 plasmids, and the insertion of ISEcp1 or IS26 was observed at the 48 bp or 45 bp upstream of the start codon of bla(CTX-M-55) gene. The dissemination of bla(CTX-M-55) gene among E. coli UTI isolates, appeared to be due to both the major clonal lineage of ST1193 and the horizontal transfer of epidemic plasmid Incl1/ST16.