Detection of the ST111 Global High-Risk Clone in a Subway Underpass.

strain NL201 was cultured from an urban water drain in a populated subway underpass as an environmental isolate for the ST111 global high-risk clone. In addition to carrying generally present intrinsic antibiotic resistance genes, this serotype O4 isolate also carries a set of additional acquired resistance determinants, including , , , and an family gene. The NL201 isolate features the allele, which was found to confer significantly higher catalytic efficiency against cefepime and imipenem compared to , as well as the potent virulence factors , and Serotype O4 isolates of the ST111 global high-risk clone have been reported from clinical samples in Canada and the USA, human stool samples in France, and environmental samples (such as cosmetic, hospital drains, and urban water drain) from various European countries. These observations underscore the effective dissemination of the ST111 global high-risk clone between different hosts, environments, and habitats, and they warrant targeted investigations from a One Health perspective on the possible routes of its spread and molecular evolution.