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Extended-spectrum beta-lactamases (ESBL) and AmpC producing- Escherichia coli  have spread worldwide, but data about ESBL-producing- E. coli  in the Northern and Eastern regions of Europe is scant. The aim of this study has been to describe the phenotypical and molecular epidemiology of different ESBL/AmpC/Carbapenemases genes in  E. coli  strains isolated from the Baltic States (Estonia, Latvia, and Lithuania), Norway and St. Petersburg (Russia), and to determine the predominant multilocus sequence type and single nucleotide polymorphisms diversity of  E. coli  isolates deduced by whole genome sequencing (WGS). A total of 10,780 clinical  E. coli  strains were screened for reduced sensitivity to third-generation cephalosporins. They were collected from 21 hospitals located in Estonia, Latvia, Lithuania, Norway and St. Petersburg during a 5 month period in 2012. The overall prevalence of ESBL/AmpC strains was 4.7% by phenotypical test and 3.9% by sequencing. We found more strains with the ESBL/AmpC phenotype and genotype in St. Petersburg and Latvia than other countries. Of phenotypic  E. coli  strains, 85% contained confirmed ESBL genes (including  bla  CTX–M ,  bla  TEM–  29 ,  bla  TEM–  71 ), AmpC genes ( bla  CMY–  59 ,  bla  ACT–  12  /  –  15  /  –  20 ,  bla  ESC–  6 ,  bla  FEC–  1 ,  bla  DHA–  1 ), or carbapenemase genes ( bla  NDM–  1 ).  bla  CTX–M–  1 ,  bla  CTX–M  –  14  and  bla  CTX–M–  15  were found in all countries, but  bla  CTX–M–  15  prevalence was higher in Latvia than in St. Petersburg (Russia), Estonia, Norway and Lithuania. The dominating AmpC genes were  bla  CMY–  59  in the Baltic States and Norway, and  bla  DHA–  1  in St. Petersburg.  E. coli  strains belonged to 83 different sequence types, of which the most prevalent was ST131 (40%). In conclusion, we generally found low ESBL/AmpC/Carbapenemase prevalence in  E. coli  strains isolated in Northern/Eastern Europe. However, several inter-country differences in distribution of particular genes and multilocus sequence types were found.

Phenotypic and Molecular Epidemiology of ESBL-, AmpC-, and Carbapenemase-Producing Escherichia coli in Northern and Eastern Europe