E. coli resistance has grown steadily since early 2000s, Wellcome Sanger Institute and University of Oslo confirm
The biggest genomic survey of E. coli to date has shown that its antibiotic resistance has been steadily increasing since the early 2000s, despite our attempts to control it.
Researchers have managed to track the spread of antibiotic resistant genes - and shown that they are being transferred between E. coli strains.
The work has taken more than 16 years in Norway.
Researchers from the Wellcome Sanger Institute and the University of Oslo have also compared multidrug resistance in Norway to a previous UK study.
They learned that resistant strains developed around the same time, but increased more rapidly in the UK population - possibly because it is larger.
The Escherichia coli bacterium is commonly found in the gut, where it does not cause harm. But if it gets into the bloodstream due to a weakened immune system, it can causes severe and life-threatening infections.
Multi-drug resistance (MDR) has become a regular feature in these infections, leaving limited treatment options in a worrying number of cases.
Analysing sample from 3,200 patients in Norway over 16 years using large-scale DNA sequencing, the study, published in Lancet Microbe, shows tracking the resistant strains can be important in controlling these infections, while understanding the transfer of genes between them can help prevent the growth of these strains.
Multiple MDR E. coli strains are now present in Norway and these are more widely present in the UK, with more research needed to fully understand why.
Professor Jukka Corander, co-author and associate faculty member at the Wellcome Sanger Institute, said: “The high number of samples from the Norwegian population and the level of genomic detail on the strains of bacteria enabled us to make much more far-reaching conclusions than were ever possible before. This study demonstrates the power arising from a systematic national surveillance of resistant organisms, which both collects and makes the data available for in-depth analyses. Without these in place, it would have been impossible to approach the central research questions formulated in the study and find answers to them.”
Lineages not thought to have MDR have been shown in the study to have acquired drug-resistance genes. This shows the increased ability of E.coli to share MDR genes that move horizontally between strains.
Dr Rebecca Gladstone, lead author of the study and bioinformatician at the University of Oslo, Norway, said: “Being able to estimate the expansion timelines of the MDR clones of E. coli and to identify multiple occasions of novel acquisition of resistance genes is particularly exciting as this is the first time that this has been possible. Understanding and tracking the movement of these drug resistance genes and the strains that carry them are necessary for controlling the spread of drug-resistant bacteria, which is a huge issue in healthcare.”
Professor Julian Parkhill, co-author and professor in the Department of Veterinary Medicine at University of Cambridge, added: “Long-term studies such as this one provide in-depth understanding about the complex epidemiology underlying bloodstream infections. The next step would be further research to detail the factors determining the success of emerging pathogenic clones of these bacteria, to help find a way to control and possibly minimise the spread of multidrug resistance.”
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