Clonal spread in Eastern Asia of ciprofloxacin-resistant Escherichia coli serogroup O25 strains, and associated virulence factors.

A significant problem in the field of infectious diseases is the increase in fluoroquinolone (FQ)-resistant Escherichia coli. Although mutation of strains and clonal dissemination are supposed to be the cause of this increase, little is known about the prevalence of this organism. We investigated 219 FQ-resistant E. coli strains in Japan and nine Asian countries by serotyping and genotyping. Seventy-one strains (32.4%) were serogroup O25, which was prevalent in South Korea, China and Japan, especially in the southwest part of Japan. Aerobactin, a virulence factor in uropathogenic and avian pathogenic E. coli, was associated with the presence of FQ-resistant O25 strains of E. coli. Seven of the seventy-one FQ-resistant E. coli O25 had extended-spectrum beta-lactamase genes (six CTX-M-14 and one SHV-12), however, we were unable to find any E. coli O25-ST131 clone that produced CTX-M-15, which was previously reported to have emerged across continents. These data demonstrate that a clonal group of FQ-resistant and virulent E. coli recently became prevalent at least in East Asia and suggest that this might become a public health problem because the strains may acquire resistance to other antimicrobial agents.