{"doi":"10.17615/80k1-hy64","title":"Genomic Analysis of Multidrug-Resistant Escherichia coli from North Carolina Community Hospitals: Ongoing Circulation of CTX-M-Producing ST131- H 30Rx and ST131- H 30R1 Strains","abstract":"ABSTRACT Escherichia coli sequence type 131 (ST131) predominates globally among multidrug-resistant (MDR) E. coli strains. We used whole-genome sequencing (WGS) to investigate 63 MDR E. coli isolates from 7 North Carolina community hospitals (2010 to 2015). Of these, 39 (62%) represented ST131, including 37 (95%) from the ST131- H 30R subclone: 10 (27%) from its H 30R1 subset and 27 (69%) from its H 30Rx subset. ST131 core genomes differed by a median of 15 (range, 0 to 490) single-nucleotide variants (SNVs) overall versus only 7 within H 30R1 (range, 3 to 12 SNVs) and 11 within H 30Rx (range, 0 to 21). The four isolates with identical core genomes were all H 30Rx. Epidemiological and clinical characteristics did not vary significantly by strain type, but many patients with MDR E. coli or H 30Rx infection were critically ill and had poor outcomes. H 30Rx isolates characteristically exhibited fluoroquinolone resistance and CTX-M-15 production, had a high prevalence of trimethoprim-sulfamethoxazole resistance (89%), sul1 (89%), and dfrA17 (85%), and were enriched for specific virulence traits, and all qualified as extraintestinal pathogenic E. coli . The high overall prevalence of CTX-M-15 appeared to be possibly attributable to its association with the ST131- H 30Rx subclone and IncF[F2:A1:B−] plasmids. Some phylogenetically clustered non-ST131 MDR E. coli isolates also had distinctive serotypes/ fimH types, fluoroquinolone mutations, CTX-M variants, and IncF types. Thus, WGS analysis of our community hospital source MDR E. coli isolates suggested ongoing circulation and differentiation of E. coli ST131 subclones, with clonal segregation of CTX-M variants, other resistance genes, Inc-type plasmids, and virulence genes.","journal":"UNC Libraries","year":2020,"id":114763,"datarank":0.41360866560096265,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"self_citation_contribution":0.24141568686511508,"citation_network_contribution":0.17219297873584757,"self_endowment_contribution":0.24141568686511508,"citer_contribution":0.17219297873584757,"corpus_percentile":55.341533225032876,"corpus_rank":5774,"citation_count":4,"citer_count":4,"citers_with_citation_signal":2,"citers_with_endowment":2,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5913,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":539344,"name":"William A. Rutala","orcid":"0009-0008-4635-8709","position":1,"is_corresponding":false},{"id":539345,"name":"Hajime Kanamori","orcid":"0000-0003-3026-5272","position":2,"is_corresponding":false},{"id":393167,"name":"Deverick J. Anderson","orcid":"0000-0001-6882-5496","position":3,"is_corresponding":false},{"id":539346,"name":"Timothy J. Johnson","orcid":"0000-0001-7556-9347","position":4,"is_corresponding":false},{"id":539347,"name":"James R. Johnson","orcid":"0000-0002-4235-7943","position":5,"is_corresponding":false},{"id":517611,"name":"Christian M. Parobek","orcid":"0000-0002-4511-3493","position":6,"is_corresponding":false},{"id":539348,"name":"Brian Johnston","orcid":"0000-0001-7347-9276","position":7,"is_corresponding":false},{"id":388578,"name":"David J. Weber","orcid":"0000-0003-1726-4435","position":8,"is_corresponding":false},{"id":270632,"name":"Jonathan J. Juliano","orcid":"0000-0002-0591-0850","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-18T23:13:33.226937Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}