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Extra-intestinal pathogenic  Escherichia coli  (ExPEC) is one of the world’s leading causes of bloodstream infections with high mortality. Sequence type 410 (ST410) is an emerging ExPEC clone resistant to a wide range of antibiotics. In this study, we investigated the epidemiology of 21 ST410  E. coli  isolates from two Ghanaian hospitals. We also investigated the isolates within a global context to provide further insight into the dissemination of this highly pathogenic clone. A phylogenetic tree of the 21 isolate genomes, along with 102 others from global collection, was constructed representing the ensuing clades and sub-clades of the ST: A/H53, B2/H24R, B3/H24Rx, and B4/H24RxC. The carbapenem-resistant sub-clade B4/H24RxC is reported to have emerged in the early 2000s when ST410 acquired an IncX3 plasmid carrying a  bla  OXA–  181  carbapenemase gene, and a second carbapenemase gene,  bla  NDM–  5 , on a conserved IncFII plasmid in 2014. We identified, in this study, one  bla  OXA–  181 –carrying isolate belonging to B4/H24RxC sub-lineage and one carrying  bla  NDM–  1  belonging to sub-lineage B3/H24Rx. The  bla  OXA–  181  gene was found on a 51kb IncX3 plasmid; pEc1079_3. The majority (12/21) of our Ghanaian isolates were clustered with international strains described by previous authors as closely related strains to B4/H24RxC. Six others were clustered among the ESBL-associated sub-lineage B3/H24Rx and three with the globally disseminated sub-lineage B4/H24RxC. The results show that this highly pathogenic clone is disseminated in Ghana and, given its ability to transmit between hosts, it poses a serious threat and should be monitored closely.

Possible Dissemination of Escherichia coli Sequence Type 410 Closely Related to B4/H24RxC in Ghana