Carbapenemase- and Colistin Resistant Escherichia coli Strains from Children in China: High Genetic Diversity and First Report of bla_NDM-5, bla_CTX-M-65, bla_OXA-10, bla_TEM-1, and mcr-1.1 Genes Co-Occurrence in E. coli ST156

Figures & data

Table 1 Susceptibility to the Antimicrobial Agents, Clinical Characterization and Phenotypic Detection of E. coli

Strain ID	ST Type	Patient’s Age	Specimen Source	Isolation Date	MIC (μg/mL)
					CAZ	FEP	TZP	IPM	LVX	AMK	COL
IR594	ST7125	2Y6M10D	Pus	2019.05	≥64^R	16^R	≥128^R	≥16^R	2^R	≤2^S	4^R
IR596	ST10	3Y6M	Pus	2019.06	≥64^R	≥32^R	≥128^R	≥16^R	≥8^R	≤2^S	4^R
19IR1045	ST131	2Y7M	Cyst Fluid	2019.09	≥64^R	≥32^R	≥128^R	≥16^R	1^I	≤2^S	>64^R
20IR1127	ST156	2M18D	Pus	2020.10	≥64^R	≥32^R	≥128^R	≥16^R	≥8^R	≤2^S	4^R
20IR1128	ST457	3Y10M	Stool	2020.11	≥64^R	≥32^R	≥128^R	≥16^R	≥8^R	≤2^S	4^R

Note: ^R: Resistant; ^I: Intermediate resistant; ^S: Sensitive.

Abbreviations: ST, sequence type; MIC, minimum inhibitory concentration; Y, year; M, month; D, day; CAZ, ceftazidime; FEP, cefepime; TZP, piperacillin/tazobactam; IPM, imipenem; LVX, levofloxacin; AMK, amikacin; COL, colistin.

Figure 1 Results of resistance-related mechanisms of 5 carbapenems and colistin co-resistant Escherichia coli strains. The black squares in the figure represent positive results, the pale yellow squares represent no mutation results, and the wathet blue squares represent mutations resistance.

Table 2 Efflux Pump Gene, Integron and Virulence Gene Distribution Characteristics of 5 Strains of Clinically Isolated E. coli

Strain ID	ST Type	Resistance Gene	Efflux Pump Gene	Integron	Virulence Gene
IR594	ST7125	blaNDM-5, blaTEM-1, blaCMY-2, blaEC-8, mcr-1.1	emrE, emrD, mdtM, acrF	In498	fimA-I, iroN, iucA-D, iutA
IR596	ST10	blaNDM-5, blaCTX-M-14, blaEC, mcr-1.1	emrE, emrD, mdtM, acrF	In1411	fimA-I, papB, papI, rcsB
19IR1045	ST131	blaNDM-5, blaCTX-M-14, blaTEM-1, blaEC-5	emrE, emrD, acrF	/	fimA-I, fyuA/psn, hlyA-D, iucA-D, iutA, papC, papG
20IR1127	ST156	blaNDM-5, blaOXA-10, blaCTX-M-65, blaTEM-1, blaEC-18, mcr-1.1	emrE, emrD, mdtM, acrF	/	fimA-I, rcsB
20IR1128	ST457	blaNDM-9, blaCTX-M-199, blaTEM-1, blaEC-8, mcr-1.1	emrE, emrD, mdtM, acrF	In1249	fimA-I, rcsB