Insights and genetic features of extended-spectrum beta-lactamase producing Escherichia coli isolates from two hospitals in Ghana

<jats:title>Abstract</jats:title><jats:p>Recently, the emergence and rapid dissemination of extended-spectrum beta-lactamase (ESBL)-producing bacteria, particularly of the family Enterobacteriaceae, has posed serious healthcare challenges. Here, we determined the antimicrobial susceptibility and genetic characteristics of 164 <jats:italic>Escherichia coli</jats:italic> strains isolated from infected patients in two hospitals in Ghana. In total, 102 cefotaxime-resistant isolates (62.2%) were identified as ESBL-producers. Multilocus sequence typing of the ESBL-producers identified 20 different sequence types (STs) with ST131 (n = 25, 24.5%) as the dominant group. Other detected STs included ST410 (n = 21, 20.6%) and ST617 (n = 19, 18.6%). All identified ESBL-producers harbored <jats:italic>bla</jats:italic><jats:sub>CTX-M-14</jats:sub>, <jats:italic>bla</jats:italic><jats:sub>CTX-M-15</jats:sub>, or <jats:italic>bla</jats:italic><jats:sub>CTX-M-27</jats:sub>, with <jats:italic>bla</jats:italic><jats:sub>CTX-M-15</jats:sub> (n = 96, 94.1%) being the most predominant ESBL allele. Further analysis showed that the immediate genetic environment around <jats:italic>bla</jats:italic><jats:sub>CTX-M-15</jats:sub> is conserved within <jats:italic>bla</jats:italic><jats:sub>CTX-M-15</jats:sub> containing strains. Five of the 25 ST131 isolates were clustered with clade A, one with sub-clade C1, and 19 with the dominant sub-clade C2. The results show that fluoroquinolone-resistant, <jats:italic>bla</jats:italic><jats:sub>CTX-M-14</jats:sub>- and <jats:italic>bla</jats:italic><jats:sub>CTX- M-15</jats:sub>-producing ESBL <jats:italic>E</jats:italic>. <jats:italic>coli</jats:italic> ST131 strains belonging to clade A and sub-clades C1 and C2 are disseminating in Ghanaian hospitals. To the best of our knowledge, this is the first report of the ST131 phylogeny in Ghana.</jats:p>