Global epidemiology and molecular characterization of OXA-48-like carbapenemase-producing E. coli: a genomic analysis

Abstract Escherichia coli ( E. coli ) represents a major source for the dissemination of OXA-48-like carbapenemases, posing a significant public health threat. However, the global distribution and genetic characterization of E. coli genomes harboring OXA-48-like carbapenemase variants remain unclear. Here, we systematically analyzed the global distribution of E. coli harboring OXA-48-like carbapenemase variants based on 4,886 publicly available genomes. OXA-48-like carbapenemase-producing E. coli genomes were distributed in 71 countries, with the highest numbers of France, the United Kingdom, and the United States. A total of nine variants were identified, with bla OXA−48 being the most common, followed by bla OXA−181 and bla OXA−244 . Notably, bla OXA−181 displayed a wider geographical distribution than bla OXA−48 and bla OXA−244 . Moreover, the proportion of bla OXA−181 has significantly increased in recent years, suggesting an emerging risk related to bla OXA−181 . Comparative analysis showed that the three dominate OXA-48-like carbapenemase variants displayed specific preferences for MLST lineages, plasmid backgrounds, antibiotic resistance genes, and virulence genes. ST38, ST410, and ST38 were the predominate sequence types for bla OXA−48 -, bla OXA−181 - and bla OXA−244 -positive genomes, respectively. Moreover, the bla OXA−48 , bla OXA−181 and bla OXA−244 genes were distributed in different phylogenetic lineages across ST38 and ST410, thereby demonstrating their distinct evolutionary paths. In addition, frequent clonal transmission events were identified across a “One health” continuum. Overall, this study provides an updated insight into the global epidemiology of E. coli harboring OXA-48-like carbapenemase variants, underscoring the need for continuous monitoring of the dissemination of these variants.