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Investigating the zoonotic origins of ESBL-producing E. coli in community-acquired urinary tract infections in Ecuador
Journal article   Open access   Peer reviewed

Investigating the zoonotic origins of ESBL-producing E. coli in community-acquired urinary tract infections in Ecuador

Yashan Wang, Daniel E. Park, Maliha Aziz, Liseth Salinas, Edward Sung, Søren Hallstrøm, Cindy M. Liu, Marc Stegger, Zhenke Wu, Gabriel Trueba, …
Microbiology spectrum, e0332525
2026
DOI: https://doi.org/10.1128/spectrum.03325-25
PMID: 41949318
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Open Access CC BY V4.0

Abstract

Antibiotic Use in Agriculture Antimicrobial Resistance Bacterial Pathogenesis Clinical Microbiology Clinical Microbiology and Infectious Diseases Coliform Bacteria Environmental and Food Microbiology Escherichia Coli in Food Fecal Contamination Indicators Pathogenic Escherichia Coli Public Health Microbiology Research Article Urinary Tract Infections and Colonization Water Microbiology Zoonotic and Vector-Borne Diseases Zoonotic Bacterial Infections
Extended-spectrum β-lactamase-producing Escherichia coli (ESBL-producing E. coli) pose a growing global health threat. Although Latin America has been identified as a global hotspot of antimicrobial resistance, the zoonotic contribution to drug-resistant infections in the region remains poorly defined. We analyzed 137 clinical ESBL-producing E. coli isolates from urinary tract infections (UTIs) in Quito, Ecuador, applying a Bayesian latent class model informed by host-associated mobile genetic elements to estimate the fraction of infections attributable to food-animal sources. We estimated that 25.5% (35/137) of UTI isolates were putative zoonotic cases. This proportion rose to 42.5% after excluding ST131-H30, a human-associated pandemic lineage. Putative zoonotic isolates were enriched for animal-associated β-lactamase genes (e.g., blaTEM-1B, blaCTX-M-65), lacked human-associated markers such as blaOXA-1, and exhibited diverse antimicrobial resistance gene profiles resembling those observed among food-animal isolates. These isolates were also enriched for ColV-associated virulence genes typically linked to avian pathogenic E. coli. Putative zoonotic strains contributed substantially to third-generation cephalosporin-resistant UTIs in Quito, Ecuador, challenging assumptions derived from high-income settings that such infections are driven predominantly by human-to-human transmission. These findings highlight the importance of integrated One Health surveillance and mitigation, particularly in low- and middle-income countries where gaps in water, sanitation, and hygiene (WASH) may interact with antimicrobial use in food production to amplify antimicrobial resistance transmission.IMPORTANCEESBL-producing E. coli have rapidly emerged as a major global antimicrobial resistance threat. In Latin America, cephalosporins are commonly used in food-animal production, fueling the emergence of ESBL-producing E. coli. In low- and middle-income countries, excessive antimicrobial use driven by poorly regulated over-the-counter sales, combined with inadequate water, sanitation, and hygiene (WASH) infrastructure, can facilitate antimicrobial-resistant pathogen transmission from food animals to humans. Using a novel statistical-genomic approach, we found that over one in four cephalosporin-resistant UTIs in Quito, Ecuador, may be caused by E. coli strains originating from food animals. Our findings highlight the public health risks associated with antimicrobial use in food-animal production and the role of environmental and infrastructure-related vulnerabilities. As global demand for animal protein continues rising in middle-income countries, controlling zoonotic antimicrobial resistance transmission becomes increasingly urgent for protecting human health through integrated One Health strategies.

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