Genotyping Characteristics of Human Fecal Escherichia coli and Their Association with Multidrug Resistance in Miyun District, Beijing

Objective To explore the genotyping characteristics of human fecal Escherichia coli(E. coli) and the relationships between antibiotic resistance genes(ARGs) and multidrug resistance(MDR) of E. coli in Miyun District, Beijing, an area with high incidence of infectious diarrheal cases but no related data.Methods Over a period of 3 years, 94 E. coli strains were isolated from fecal samples collected from Miyun District Hospital, a surveillance hospital of the National Pathogen Identification Network. The antibiotic susceptibility of the isolates was determined by the broth microdilution method. ARGs,multilocus sequence typing(MLST), and polymorphism trees were analyzed using whole-genome sequencing data(WGS).Results This study revealed that 68.09% of the isolates had MDR, prevalent and distributed in different clades, with a relatively high rate and low pathogenicity. There was no difference in MDR between the diarrheal(49/70) and healthy groups(15/24).Conclusion We developed a random forest(RF) prediction model of TEM.1 + baeR + mphA + mphB +QnrS1 + AAC.3-IId to identify MDR status, highlighting its potential for early resistance identification. The causes of MDR are likely mobile units transmitting the ARGs. In the future, we will continue to strengthen the monitoring of ARGs and MDR, and increase the number of strains to further verify the accuracy of the MDR markers.

Pathogen Spectrum of Hand,Foot,and Mouth Disease Based on Laboratory Surveillance—China,2018

What is already known about this topic?Enterovirus 71(EV-A71)is the main causative pathogen for severe and fatal patients with Hand,Foot,and Mouth Disease(HFMD)in China's Mainland from 2008 to 2017.Non-EV-A71 and non-CV-A16(other enterovirus)serotypes were the major causativeserotypes for mild HFMD in years of 2013,2015,and 2017.What is added by this report?In 2018,other enterovirus serotypes replaced EV-A71 for the first time as the major cause of severe HFMD with a proportion of 70.7%.However,at the national level,only a small proportion of the other enterovirus serotypes were further identified as CV-A6 and CVA10.What are the limitations for public health practice?Further identification of other enterovirus serotypes is highly recommended for provincial CDCs,especially for severe HFMD.Studies contributing to a multivalent vaccine for HFMD should be prioritized.