Extended-spectrum beta-lactamase- and carbapenemase-producing <i>Escherichia coli</i> isolates causing hospital- and community-acquired infections in Tunisia (2001–2019): expansion of CTX-M-15-C2 and CTX-M-27-C1 ST131 subclades

We aimed to investigate the microbiological features of extended-spectrum beta-lactamase (ESBL)-producing <i>Escherichia coli</i> (ESBL-EC) and carbapenemase-producing <i>E. coli</i> (CP-EC) causing hospital- and community-acquired infections in Tunisia over the last two decades. The study captured the emergence and expansion of the CTX-M-15-C2 ST131 subclade and successively the CTX-M-27-C1 ST131 subclade, which were responsible for the steady increase in the prevalence of ESBL-EC. However, the incidence of CP-EC remained stable over the study period with a highly diverse content in carbapenemase genes dominated by blaOXA-48-like. This is the first study to provide comprehensive data on the epidemiology of ESBL-EC and CP-EC in a North African country.