{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:09:51Z","timestamp":1778821791883,"version":"3.51.4"},"reference-count":66,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Patients undergoing cervical conization for cervical intraepithelial neoplasia grade II (CIN II) may develop postoperative bloodstream infections (BSIs), and multidrug-resistant (MDR) Escherichia coli isolates with distinct resistance profiles can complicate antimicrobial management. In this case-based study, two E. coli strains, HBFY-1 and HBFY-2, were recovered from blood cultures obtained from a 38-year-old CIN II patient with postoperative fever. The isolates were characterized by antimicrobial susceptibility testing, whole-genome sequencing, conjugation assays, and comparative genomics against publicly available genomes matched by sequence type and serotype. Fever occurred on postoperative day 2. HBFY-1 was fluoroquinolone-resistant; belonged to ST744\/O101:H9; carried the extended-spectrum \u03b2-lactamase (ESBL) gene blaCTX-M-27; was phenotypically confirmed as an ESBL producer; and grouped within a multi-source near-neighbor clade consistent with a conserved fluoroquinolone-associated resistance backbone in ST744\/O101:H9. HBFY-2 was carbapenem-resistant; belonged to ST48\/O113:H32; carried blaNDM-5 on an IncY-associated plasmid bin; was phenotypically confirmed as a metallo-carbapenemase producer; and did not harbor any ESBL gene. Within the matched ST48\/O113:H32 dataset, blaNDM-5 was detected only in HBFY-2, which clustered within an Asia-enriched lineage, including China-derived human and swine genomes. The blaCTX-M-27-associated and blaNDM-5-associated elements were transferred to E. coli C600 at frequencies of 5.3 \u00d7 10\u22122 and 4.6 \u00d7 10\u22126, respectively, and transfer of the blaNDM-5-associated element imposed no detectable growth penalty under the tested conditions. As this study is based on a single clinical case, the findings should be interpreted cautiously, yet they still highlight the potential value of integrating susceptibility testing with rapid genomic characterization for identifying mobilizable carbapenem-resistance platforms.<\/jats:p>","DOI":"10.3390\/pathogens15050476","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:43:51Z","timestamp":1777448631000},"page":"476","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Two Multidrug-Resistant Escherichia coli Isolates from Blood Cultures After Cervical Conization in a Patient with Cervical Intraepithelial Neoplasia Grade II: Phenotypic and Genomic Characterization"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3316-0499","authenticated-orcid":false,"given":"Jingrui","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, The Fourth Hospital of Shijiazhuang, Shijiazhuang 050011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6204-1314","authenticated-orcid":false,"given":"Xiao","family":"Liu","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Fourth Hospital of Shijiazhuang, Shijiazhuang 050011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeshun","family":"Fan","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiwen","family":"Sun","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengjie","family":"Li","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China"},{"name":"School of Public Health, Lanzhou University, Lanzhou 730000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6154-6902","authenticated-orcid":false,"given":"Yanwen","family":"Xiong","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0327-6033","authenticated-orcid":false,"given":"Zengbin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Second Hospital of Hebei Medical University, Shijiazhuang 050061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9830-6574","authenticated-orcid":false,"given":"Yanfang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang 050061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lili","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongru","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of The North Campus, The Second Hospital of Hebei Medical University, Shijiazhuang 050061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2372-1532","authenticated-orcid":false,"given":"Duochun","family":"Wang","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingxiao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The Fourth Hospital of Shijiazhuang, Shijiazhuang 050011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"ref_1","first-page":"17","article-title":"Cervical human papillomavirus infection and intraepithelial neoplasia: A 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