{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:14:17Z","timestamp":1791429257033,"version":"4.3.3"},"reference-count":54,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2013,12,17]],"date-time":"2013-12-17T00:00:00Z","timestamp":1387238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/3.0\/"},{"start":{"date-parts":[[2013,12,31]],"date-time":"2013-12-31T00:00:00Z","timestamp":1388448000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["mBio"],"published-print":{"date-parts":[[2013,12,31]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The\n            <jats:named-content content-type=\"genus-species\">Escherichia coli<\/jats:named-content>\n            sequence type 131 (ST131) clone is notorious for extraintestinal infections, fluoroquinolone resistance, and extended-spectrum beta-lactamase (ESBL) production, attributable to a CTX-M-15-encoding mobile element. Here, we applied pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing to reconstruct the evolutionary history of the ST131 clone. PFGE-based cluster analyses suggested that both fluoroquinolone resistance and ESBL production had been acquired by multiple ST131 sublineages through independent genetic events. In contrast, the more robust whole-genome-sequence-based phylogenomic analysis revealed that fluoroquinolone resistance was confined almost entirely to a single, rapidly expanding ST131 subclone, designated\n            <jats:italic>H<\/jats:italic>\n            30-R. Strikingly, 91% of the CTX-M-15-producing isolates also belonged to a single, well-defined clade nested within\n            <jats:italic>H<\/jats:italic>\n            30-R, which was named\n            <jats:italic>H<\/jats:italic>\n            30-Rx due to its more extensive resistance. Despite its tight clonal relationship with\n            <jats:italic>H<\/jats:italic>\n            30Rx, the CTX-M-15 mobile element was inserted variably in plasmid and chromosomal locations within the\n            <jats:italic>H<\/jats:italic>\n            30-Rx genome. Screening of a large collection of recent clinical\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            isolates both confirmed the global clonal expansion of\n            <jats:italic>H<\/jats:italic>\n            30-Rx and revealed its disproportionate association with sepsis (relative risk, 7.5;\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001). Together, these results suggest that the high prevalence of CTX-M-15 production among ST131 isolates is due primarily to the expansion of a single, highly virulent subclone,\n            <jats:italic>H<\/jats:italic>\n            30-Rx.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>IMPORTANCE<\/jats:bold>\n            We applied an advanced genomic approach to study the recent evolutionary history of one of the most important\n            <jats:named-content content-type=\"genus-species\">Escherichia coli<\/jats:named-content>\n            strains in circulation today. This strain, called sequence type 131 (ST131), causes multidrug-resistant bladder, kidney, and bloodstream infections around the world. The rising prevalence of antibiotic resistance in\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            is making these infections more difficult to treat and is leading to increased mortality. Past studies suggested that many different ST131 strains gained resistance to extended-spectrum cephalosporins independently. In contrast, our research indicates that most extended-spectrum-cephalosporin-resistant ST131 strains belong to a single highly pathogenic subclone, called\n            <jats:italic>H<\/jats:italic>\n            30-Rx. The clonal nature of\n            <jats:italic>H<\/jats:italic>\n            30-Rx may provide opportunities for vaccine or transmission prevention-based control strategies, which could gain importance as\n            <jats:italic>H<\/jats:italic>\n            30-Rx and other extraintestinal pathogenic\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            subclones become resistant to our best antibiotics.\n          <\/jats:p>","DOI":"10.1128\/mbio.00377-13","type":"journal-article","created":{"date-parts":[[2013,12,18]],"date-time":"2013-12-18T04:32:50Z","timestamp":1387341170000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":422,"title":["The Epidemic of Extended-Spectrum-\u03b2-Lactamase-Producing Escherichia coli ST131 Is Driven by a Single Highly Pathogenic Subclone,\n            <i>H<\/i>\n            30-Rx"],"prefix":"10.1128","volume":"4","author":[{"given":"Lance B.","family":"Price","sequence":"first","affiliation":[{"name":"Division of Pathogen Genomics, the Translational Genomics Research Institute, Flagstaff, Arizona, USA"},{"name":"Department of Occupational and Environmental Health, George Washington University, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Veterans Affairs Medical Center and University of Minnesota, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maliha","family":"Aziz","sequence":"additional","affiliation":[{"name":"Division of Pathogen Genomics, the Translational Genomics Research Institute, Flagstaff, Arizona, USA"},{"name":"Department of Occupational and Environmental Health, George Washington University, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connie","family":"Clabots","sequence":"additional","affiliation":[{"name":"Veterans Affairs Medical Center and University of Minnesota, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Johnston","sequence":"additional","affiliation":[{"name":"Veterans Affairs Medical Center and University of Minnesota, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Tchesnokova","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Washington School of Medicine, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lora","family":"Nordstrom","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Health, George Washington University, Washington, DC, 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