Dissemination of IncF group F1:A2:B20 plasmid-harboring multidrug-resistant Escherichia coli ST131 before the acquisition of blaCTX-M in Japan.

Abstract Objectives The Escherichia coli O25-ST131 clone is responsible for global dissemination of blaCTX-M. However, the prevalence of this clone in the digestive tract, devoid of antimicrobial selection, and its molecular epidemiology remain unclear. In this study, we examined the origin of blaCTX-M-positive E. coli O25-ST131 and its distribution. Methods We separately sequenced the chromosomal and plasmid genomes of 50 E. coli O25 isolates obtained from fecal samples of patients with diarrhea in Japan. Results Although 36 of 50 (72%) E. coli O25 isolates were ST131, only 6 harbored blaCTX-M. According to the fimH and ybbW sequences and fluoroquinolone susceptibility, H30R1 isolates were dominant (27/36; 75%) and possessed IncFII-FIA-FIB with FAB formula subtype F1:A2:B20 plasmids at a high frequency (25/27; 93%). The F1:A2:B20 plasmids possessed more resistance genes such as blaTEM-1, aminoglycoside resistance genes, and sulfamethoxazole-trimethoprim resistance genes compared to non-F1:A2:B20 plasmids. In contrast, only one blaCTX-M-14 was located on the F1:A2:B20 plasmids, whereas the other three were located on IncFII (F4:A-:B-) (n = 1) and IncZ plasmids (n = 2). Two H30Rx-ST131 isolates harbored blaCTX-M-15: one was on the chromosome and the other on the IncFIA-R plasmid. The stability and conjugation ability of the F1:A2:B20 plasmids were compared with those of non-F1:A2:B20 plasmids, which revealed higher stability but were less conjugative ability. Conclusions These results suggest that E. coli H30R1-ST131 is a multidrug-resistant clone containing several resistance genes in the F1:A2:B20 plasmid, which were widely distributed before the acquisition of blaCTX-M.