Antimicrobial Resistance and Comparative Genome Analysis of High-Risk Escherichia coli Strains Isolated from Egyptian Children with Diarrhoea

<i>Escherichia coli</i> is an important human pathogen that is able to cause a variety of infections, which can result in diarrhoea, urinary tract infections, sepsis, and even meningitis, depending on the pathotype of the infecting strain. Like many Gram-negative bacteria, <i>E. coli</i> is becoming increasingly resistant to many frontline antibiotics, including third-generation cephalosporins and carbapenems, which are often considered the antibiotics of last resort for these infections. This is particularly the case in Egypt, where multidrug-resistant (MDR) <i>E. coli</i> is highly prevalent. However, in spite of this, few Egyptian MDR <i>E. coli</i> strains have been fully characterised by genome sequencing. Here, we present the genome sequences of ten highly MDR <i>E. coli</i> strains, which were isolated from children who presented with diarrhoea at the Outpatients Clinic of Assiut University Children's Hospital in Assiut, Egypt. We report that they carry multiple antimicrobial resistance genes, which includes extended spectrum β-lactamase genes, as well as <i>bla</i>_NDM and <i>bla</i>_OXA carbapenemase genes, likely encoded on IncX3 and IncF plasmids. Many of these strains were also found to be high-risk extra-intestinal pathogenic <i>E. coli</i> (ExPEC) clones belonging to sequence types ST167, ST410, and ST617. Thus, their presence in the Egyptian paediatric population is particularly worrying, and this highlights the need for increased surveillance of high-priority pathogens in this part of the world.