• Linlin Xiao, Xiaotong Wang, Nana Kong, Long Zhang, Mei Cao, Muzhen Sun, Quhao Wei, and Weiwei Liu.
• Department of Laboratory Medicine, Affiliated Sixth People's Hospital South Campus, Shanghai University of Medicine & Health Sciences, Shanghai, China.
• Front Microbiol. 2019 Jan 1; 10: 2175.

ObjectivesTo describe the molecular characteristics of beta-lactamases in bloodstream-infection Escherichia coli isolated from elderly patients, and to determine the genotypic patterns of bla CMY - 2 and bla ADC - 162.MethodsA total of 50 bloodstream-infection E. coli isolates were obtained from patients aged > 50 years at Shanghai Sixth People's Hospital South Campus during 2015-2018. The isolates were subjected to beta-lactamase detection using phenotypic and molecular methods. Beta-lactamase genes were verified by sequencing and the phylogenetic relationships of the isolates were analyzed by multilocus sequence typing (MLST). The transferability of plasmids carrying bla CMY- 2 and bla ADC- 162 genes was verified by conjugation experiments and plasmid replicon typing.ResultsEight beta-lactamase subtypes were detected in 50 isolates of bloodstream-infection E. coli. bla TEM- 1 (21/50) was the most common beta-lactamase gene, followed by bla CTX-M- 14 (8/50), bla OXA- 27 (5/50), bla CTX-M- 27 (3/50), bla CTX-M- 65 (1/50), bla ADC- 162 (1/50), and bla CMY- 2 (1/50). Of these, bla ADC- 162 (ST95-A), and bla CMY- 2 (ST95-B2) have not previously been reported in bloodstream-infection E. coli. In 21 isolates, beta-lactamase genes were located on conjugative plasmids belonging to incompatibility groups FrepB (n = 7), FIA (n = 1), FIC (n = 2), K (n = 8), N (n = 1), and I (n = 1), and bla CTX-M was associated with the common elements ISEcp1, IS903, and IS26, but with special sequences (region V, region Y, and region W) for ISEcp1 in 14 isolates.ConclusionTo the best of our knowledge, this study provides the first molecular characterization of beta-lactamase genes in E. coli isolated from the bloodstream in elderly patients. Beta-lactamase genes were detected at a relatively high frequency in elderly patients with bloodstream E. coli infections. Plasmid replicon analysis showed that horizontal dissemination of beta-lactamase genes was mainly mediated by IncK and IncF plasmids, which could encode multidrug resistance genes. The study also provides the first report of ISAba1-bla ADC - 162-tnpA and ISEcp1-bla CTX-M- 14-IS903-bla CMY- 2-blc-sugE in E. coli, and demonstrates IncF plasmid-mediated bla ADC - 162 and bla CMY- 2 gene dissemination among bacteria.Copyright © 2019 Xiao, Wang, Kong, Zhang, Cao, Sun, Wei and Liu.

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