Cited by 49Escherichia coli research studiesAntibiotic Resistance in BacteriaUrinary Tract Infections Management

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

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Weerdenburg, Eveline, Davies, Todd, Morrow, Brian, Zomer, Aldert L, Hermans, Peter, Go, Oscar, Spiessens, Bart, van den Hoven, Thijs +7 more·2023·Clinical Infectious Diseases

Abstract

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.

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  • E. coli Nissle 1917 has O6 repeating units for LPS, K5-type capsule, and H1-type flagella.

    “having O6 repeating units for LPS (a feature commonly found in extra-intestinal pathogenic E. coli strains), K5-type for capsule (described to make serum-resistant the extra-intestinal pathogenic E. coli strains), and H1-type for flagella (responsible for strain motility) [26, 29, 30]”

    From Selection, Comparative Genomics, and Potential Probiotic Features of Escherichia coli 5C, a pks-Negative Strain Isolated from Healthy Infant Donor Feces (2026) · cites this paper as [30]

    The Results (Other Prevalent Serotypes; page not provided) report that O6 accounted for 8.1% of the ExPEC bloodstream isolates studied, supporting the parenthetical description of O6 as common in ExPEC. Our copy does not identify E. coli Nissle 1917 as O6 or address its K5 capsule, H1 flagella, serum resistance, or motility. (LLM, conf=0.88)

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  • E. coli Nissle 1917 is characterized by an LPS-type O6, commonly found in extra-intestinal pathogenic E. coli.

    “E. coli Nissle 1917 is characterized by an LPS-type, O6, commonly found in extra-intestinal pathogenic E. coli [29, 30, 146].”

    From Selection, Comparative Genomics, and Potential Probiotic Features of Escherichia coli 5C, a pks-Negative Strain Isolated from Healthy Infant Donor Feces (2026) · cites this paper as [30]

    The Results (“Other Prevalent Serotypes”; page unavailable) report that O6 accounted for 8.1% of the ExPEC bacteremia isolates and was common across regions. The paper also identifies the O antigen as part of lipopolysaccharide, but it does not establish that E. coli Nissle 1917 has the O6 type. (LLM, conf=0.88)

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Authors
Weerdenburg, E., Davies, T., Morrow, B., Zomer, A. L., Hermans, P., Go, O., Spiessens, B., van den Hoven, T., van Geet, G., Aitabi, M., DebRoy, C., Dudley, E. G., Bonten, M., Poolman, J., & Geurtsen, J.
Affiliations
  • Janssen (Netherlands) (NL)
  • Janssen Research & Development (United States) (US)
  • Utrecht University (NL)
  • Janssen (Belgium) (BE)
  • Janssen Integrated Data Analytics & Reporting , Beerse , Belgium
  • Pennsylvania State University (US)
  • University Medical Center Utrecht (NL)
Corresponding author
  • Hermans, Peter
  • Geurtsen, Jeroen
Venue
Clinical Infectious Diseases
Published
2022-06-10
Volume
76
Issue
3
Pages
e1236-e1243
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
OpenAlex
W4281740135
Cited by
49
References
31
Citations by year
2026: 17 · 2025: 20 · 2024: 7 · 2023: 5
FWCI
5.05
Type
journal article
Language
en
Open access
Locations
  • Clinical Infectious Diseases (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
Funders
Janssen Pharmaceuticals
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Escherichia coli research studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
Keywords
extraintestinal pathogenic Escherichia coli, O serotypes, bacteremia, multidrug resistance, antibiotic resistance, serotype distribution, older adults, bloodstream infection, antimicrobial susceptibility, global surveillance
MeSH terms
Extraintestinal Pathogenic Escherichia coli, Aged, Drug Resistance, Microbial, Escherichia coli, Escherichia coli Infections, Humans, Retrospective Studies, Bacteremia, Serogroup

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