Grant: Team Grant: Joint Programming Initiative on Antimicrobial Resistance (JPIAMR)

Escherichia coli is the most common cause of community acquired urinary tract and bloodstream infections worldwide. A single clone, named ST131, is mainly responsible for the global increase of multidrug resistance amongst E. coli. The emergence of ST131 is most likely the biggest antimicrobial resistance success story of the 2000s; however it remains unclear which features resulted in the global clinical dominance of this clone. We propose a combined European-Canadian consortium that will investigate the transmission dynamics of ST131. This study will explore the mechanisms by which mobile genetic elements are successfully acquired and maintained within ST131 as well as the means by which they interact and evolve together to contribute to the fitness and evolutionary success of the ST131 C clade. The project will also investigate intestinal colonization, movement of patients, transmission modes within the community setting and non-human reservoirs of ST131. The broad goal of this project is to improve human health by better managing extra-intestinal infections due to multidrug resistant E. coli. The study will use the strengths of the different partners in this consortium to explore explanations for the global clinical dominance of ST131. The global spread of antimicrobial resistance was recently identified by the WHO as one of the three greatest threats to human health. Only by understanding how antibiotic resistance evolves and spreads in bacterial populations can we begin to overcome such resistance.