Reconciling the Potentially Irreconcilable? Genotypic and Phenotypic Amoxicillin-Clavulanate Resistance in <i>Escherichia coli</i>
T. J. Davies, Nicole Stoesser, Anna E. Sheppard, Manal AbuOun, Philip W. Fowler, Jeremy Swann, T. Phuong Quan, David Griffiths, Alison Vaughan, Marcus Morgan, Hang Phan, Katie Jeffery, Monique Andersson, M.J. Ellington, Oskar Ekelund, Neil Woodford, Amy J. Mathers, Robert A. Bonomo, Derrick W. Crook, Tim Peto, Muna F. Anjum, A Sarah Walker
Abstract
Resistance to amoxicillin-clavulanate, a widely used beta-lactam/beta-lactamase inhibitor combination antibiotic, is rising globally, and yet susceptibility testing remains challenging. To test whether whole-genome sequencing (WGS) could provide a more reliable assessment of susceptibility than traditional methods, we predicted resistance from WGS for 976 Escherichia coli bloodstream infection isolates from Oxfordshire, United Kingdom, comparing against phenotypes from the BD Phoenix (calibrated against EUCAST guidelines).