{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:03:29Z","timestamp":1784873009912,"version":"3.55.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Carbapenem-resistant (CR)-Enterobacterales are a serious threat to public health worldwide. However, there are limited surveillance data on the molecular epidemiology of CR-\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      . To address this need, the European Centre for Disease Prevention and Control (ECDC) investigated the molecular epidemiology of CR-\n                      <jats:italic>E. coli<\/jats:italic>\n                      in the carbapenem- and\/or colistin-resistant Enterobacterales (CCRE) survey launched in 2019, involving 37 European countries, including Italy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In 2019, 46 acute-care hospitals in Italy were enrolled to collect the first 10 non-duplicated consecutive isolates of carbapenem non-susceptible\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      specie complex or\n                      <jats:italic>E. coli<\/jats:italic>\n                      isolates and 10 carbapenem-susceptible comparator isolates of the same species. Each isolate was subjected to antibiotic susceptibility testing. WGS analysis was performed using Illumina technology to determine the ST and to detect resistance genes, virulence factors, and plasmid content.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 61\n                      <jats:italic>E. coli<\/jats:italic>\n                      isolates were collected from 17 hospitals: 17 CR-\n                      <jats:italic>E. coli<\/jats:italic>\n                      isolates (from urine, 41.2%, and blood, 23.5%) and 44 carbapenem-susceptible (CS)-isolates (from blood, 43.2%, and urine, 38.6%). All the CR-\n                      <jats:italic>E. coli<\/jats:italic>\n                      isolates were resistant to amoxicillin\/clavulanic acid, cefepime, ceftazidime and piperacillin\/tazobactam; three were resistant to ceftazidime\/avibactam and all were susceptible to amikacin and tigecycline. MLST analysis showed the presence of unrelated lineages: CR-\n                      <jats:italic>E. coli<\/jats:italic>\n                      isolates belonged to 8 different STs, with ST131 predominant (58.8%). All the CR-\n                      <jats:italic>E. coli<\/jats:italic>\n                      isolates carried one carbapenemase: KPC-3 (10 isolates), KPC-2 (three), NDM-5 (two), VIM-1 and OXA-181 (one each). Among CS-\n                      <jats:italic>E. coli<\/jats:italic>\n                      isolates, the highest resistance rates were observed for amoxicillin\/clavulanic acid (36.4%) followed by ciprofloxacin, and trimethoprim\/sulfamethoxazole, and ST131, carrying CTX-M-15, was the predominant clone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>\n                      CR-\n                      <jats:italic>E. coli<\/jats:italic>\n                      clones from infection showed a heterogeneous genetic background, ST131 being the most frequent. KPC was the most common carbapenemase but the presence of\n                      <jats:italic>E. coli<\/jats:italic>\n                      isolates carrying NDM-5 is worrisome, as it results in resistance to several novel beta-lactam-beta-lactamase combinations. Our study underlines the importance of genomic surveillance to monitor and prevent the spread of high-risk clones causing difficult-to-treat infections.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1875003","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:36:44Z","timestamp":1784871404000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Whole-genome sequencing and molecular analysis of carbapenem-resistant Escherichia coli from clinical samples collected in the framework of the EURGen-Net CCRE survey, Italy 2019"],"prefix":"10.3389","volume":"17","author":[{"given":"Maria","family":"Giufr\u00e8","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Errico","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Del Grosso","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Giancristofaro","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Pagnotta","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"D\u2019Ambrosio","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Iacchini","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"David","sequence":"additional","affiliation":[{"name":"Centre for Genomic Pathogen Surveillance, Pandemic Sciences Institute, University of Oxford","place":["Oxford, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alma","family":"Brolund","sequence":"additional","affiliation":[{"name":"Department of Communicable Disease Control and Preparedness, Public Health Agency of Sweden","place":["Solna, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Kohlenberg","sequence":"additional","affiliation":[{"name":"European Centre for Disease Prevention and Control","place":["Stockholm, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Pantosti","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Monaco","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Italian CCRE working group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"101402","DOI":"10.1016\/j.onehlt.2026.101402","article-title":"A one health view of antimicrobial resistance in North Africa: meta-analysis of ESBL-producing Enterobacteriaceae across sectors","volume":"22","author":"Abi","year":"2026","journal-title":"One Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e000093","DOI":"10.1099\/mgen.0.000093","article-title":"Microreact: visualizing and sharing data for genomic epidemiology and phylogeography","volume":"2","author":"Argim\u00f3n","year":"2016","journal-title":"Microb. 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