- Genome Report
- Open Access
Genome analyses of blaNDM-4 carrying ST 315 Escherichia coli isolate from sewage water of one of the Indian hospitals
© The Author(s) 2018
- Received: 14 April 2018
- Accepted: 19 May 2018
- Published: 24 May 2018
Emergence of carbapenem resistant Escherichia coli pathovars and their environmental dissemination are alarming problems. E. coli isolated from sewage water of hospital setting conferred a high resistance towards β-lactams, particularly towards carbapenem. This prompted us to perform whole genome sequence analysis to investigate the antimicrobial determinants, pathogenicity status and mobile genetic elements associated with resistance genes.
To the best of our knowledge this is the first report of ST 315 carrying NDM-4 from India. The genome analysis has revealed the unknown characteristics associated with this sequence type (ST 315) like resistance and virulence factors. Based on virulence markers, its pathotype was identified as ExPEC. Furthermore, a mobile plasmid with multiple β-lactamases genes and clinically relevant resistance markers was detected. Phylogenetic analysis of Inc F plasmids sequences carrying ESBLs and NDM variants, revealed un-relatedness in these plasmids due to their varying size and backbone sequences.
Presence of carbapenem resistant E. coli ST 315 with high level antibiotic resistance, near hospital environment is an alarming situation in context to its spread. WGS based analyses have provided details on virulence and resistance status which could overcome the lack of information available on ST 315, globally. This could further help in its quick detection and control in clinical settings.
- ST 315
- Hospital setting
Escherichia coli share a commensal relationship with humans and animals. The extensive acquisition of virulence genes has potentiated E. coli to become pathogenic . The E. coli pathotypes are identified on the basis of virulence determinants present in the genome. A pathotype, ExPEC (extra intestinal pathogenic E. coli) has been reported in extra intestinal, neonatal meningitis and septicaemia infections. Over the years ExPECs are being increasingly recognised for plasmid-mediated carriage of extended spectrum β-lactamases and carbapenemases (metallo β-lactamases, MBLs) . The emergence of a carbapenemase, New Delhi-Metallo β-lactamase (NDM-1) has conferred resistance to last resort β-lactams which has further made the management of ExPECs difficult . A single amino acid variation (Met154Leu) in NDM-1 has resulted in the emergence of a novel NDM-4 which has extended and increased hydrolytic activity towards β-lactams, especially towards carbapenem .
The bacterial isolate AK-1 found in hospital sewage water was subjected to antibiotic susceptibility testing which revealed an exorbitantly elevated MIC values against β-lactams . This unusual resistance in AK-1 strain intrigued us to further explore other genetically predisposed features through whole genome sequencing.
E. coli isolation and characterisation
The isolate for whole genome sequence analysis was collected and identified as reported in our previous published study . It was identified and characterised as NDM-4 producing E. coli strain.
Whole genome sequencing, annotation and analysis
The bacterial DNA was isolated from the AK-1 strain by Qiagen’s QIAamp DNA mini kit and GE SimpliNano UV–Vis Spectrophotometer was used to measure the concentration and purity of the DNA. The genomic DNA was subjected to whole genome sequencing on Illumina NextSeq 500 platform using the paired-end 2 × 150 nt sequencing protocol. The raw sequence data was further analysed by FastQC tool for quality control purposes . SPAdes version 3.10.1 was used to create denovo assembly with genome coverage of 266.181× . Genome annotation was performed by NCBI Prokaryotic Genome Annotation Pipeline using Best-placed reference protein set and GeneMarkS+ methodology.
StringMLST tool  was used to determine sequence type and multi-locus sequence typing database of E. coli at PubMLST (http://ukmirror1.pubmlst.org/databases.shtml)  was used as reference. The serotype of the strain (fliC, wxy and wzx genes) was determined by SerotypeFinder . Resistance genes were identified using CARD and ARDB databases [11, 12]. Virulence factors were determined using the combination of UniProt and Virulence finder database (VFDB) . Further genome analyses was done using ISfinder  and RAC . Phylogenetic analysis was done on MEGA (version 7) using plasmid sequences retrieved from GenBank.
Escherichia coli ST 315 genomic DNA was extracted from a single colony and this strain was maintained. The 16s rRNA gene from the draft genome was confirmed to check for contamination. High quality of reads were confirmed by CLC bio Genomic Workbench version 9 (CGWB) and selected for assembly.
General features of AK-1 genome
6, 2, 5 (5S, 16S, 23S)
6, 1 (5S, 16S)
1, 5 (16S, 23S)
Pseudo genes (total)
AK-1 was found to carry a plasmid of 155,678 bp (Additional file 1: Figure S1). pMLST identified plasmid belonging to IncF group having alleles, repFIB and repFII.
The genetic environment of blaTEM1b was identified to be flanked by one truncated copy of IS26. The blaTEM1b gene was associated with partial Tn2, it was present distally to tnpR-encoding gene and proximally to an IR (Fig. 1b) .
A truncated Tn2 transposon unit was found to be associated with blaCTX-M-15. It was revealed that both DRL and DRR were bracketing this unit where ISEcp1 was distally located to blaCTX-M-15 gene (Fig. 1c). This arrangement is very common and ISEcp1 is reported to mediate the mobilization of blaCTX-M-15 [20, 21].
Other previously reported resistance genes and associated mobile genetic elements were found on AK-1 plasmid. (i) Class I integron carrying qacE∆ 1, sul 2, dfrA12 and aadA2 (Fig. 1d) , (ii) rmt B was found to be associated with partial sequence of IS 26 (Fig. 1e) and upstream to blaTEM1b (not shown) , (iii) sul1 gene upstream to strA and strB genes which are bracketed by Tn 5903 , (iv) tet (A) efflux protein and its regulator tet R (A) associated with Tn1721 mobile element .
AK-1 chromosome carries wide range of resistance markers towards major classes of antibiotics like flouroquinoles, macrolides, aminoglycosides, tetracycline, trimethoprim isoniazid, triclosan, elfamycin and β-lactams (Additional file 3: Table S2). Extensive numbers of genes conferring resistance towards β-lactams were found; four types of penicillin binding proteins and class C β-lactamases, blaCFE 1 and blaPEDO 2. Accumulative effect of these genes explains the high level of phenotypic resistance towards β-lactams in AK-1 .
Type 1 fimbriae NSBV01000003 (15138–21501) sfm fimbriae NSBV01000011 (7740–14015) yad fimbriae NSBV01000005 (66168–72121) MAT(ECP) fimbriae NSBV01000007 (119869–126709) FdeC NSBV01000007 (106372–110622) Curli NSBV01000004 (93069–97942)
ChuA NSBV01000028 (31777–40728) Enterobactin NSBV01000021 (27676–46582) Aerobactin NSBV01000005 (59212–52929)
HlyA NSBV01000011 (54096–55271) HlyE NSBV01000026 (46866–47777)
TypeIII secretion system (ETT2) NSBV01000002 (15607–31153) TypeVI secretion system NSBV01000032 (5165–28659)
ColV NSBV01000002 (84476–84964) ibeB NSBV01000021 (57575–58957) K1capsule NSBV01000002 (150300–158286) ompA NSBV01000004 (166414–167466)
Haemolytic toxins were also identified in AK-1 (i) Hemolysin α is associated with ExPEC virulence and attacks immune cell , (ii) membrane pore-forming toxin HlyE lyses mammalian cells and erythrocytes .
ExPECs cope up with low iron availability by secreting siderophores which retrieves sequestered iron from host proteins . AK-1 was identified to harbour aerobactin, enterobactin and chuA siderophores. Proectins/invasins like ibeB, ompA and K1 capsule have been reported in invasion of brain microvasular endothelial cells .
The genetic context of NDM-4 in AK-1 plasmid was similar to plasmids (pM109 FII, pMC-NDM, pGUE NDM, pCRKP-2297, pCRKP-1215, pM214 FII, and pNDM5-IBAC) carrying NDM variants. The genetic environment for blaNDM remained conserved in these plasmids. This suggests that alteration in bla gene originated new NDM variants. Furthermore, genetic context of blaTEM1b and blaCTX-M-15 were almost similar in these plasmids.
Presence of plasmid harbouring blaNDM-4 and other β-lactamase genes near the hospital setting environment is a serious concern in context to its circulation and spread in hospital settings. It is the first time NDM-4 producing ST 315 E. coli was detected in India. Moreover, no genome based information on ST 315 strain is yet available. Lack of information on mechanism of virulence, transmission sources and other genetic characteristics have become an impasse for alleviation of ExPECs infections. AK-1 genome based virulence profile provides cause of serious infections by ST 315 ExPEC, a common microflora of healthy individuals. Genome informed virulence and resistance mechanisms will definitely help in identification of this ExPECs in healthcare settings and controlling the clonal spread of carbapenamase carrying E. coli pathovars.
AZB, analysed the data and wrote the first draft of the MS. AUK, provided the NGS data, helped in interpretation of the data and checked first draft. Both authors read and approved the final manuscript.
We acknowledge the support of internal funds of Biotechnology Department.
The authors declare that they have no competing interests.
Availability of data and materials
The whole genome sequence project of AK-1 is deposited to GenBank under the accession id NSBV01000000 and consists of sequences NSBV01000001–NSBV01000129. The genome draft has also been published .
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