ST1193 Escherichia coli in neonatal meningitis: emergence and clonal expansion of a CTX-M-15-chromosomally integrated sublineage (ST1193-B1-Rx) France 2012 - 2023

We report the emergence of Escherichia coli ST1193 in neonatal meningitis cases in France (2012 - 2023) with increasing ESBL-producing isolates. Short- and long-read sequencing identified a sublineage with chromosomal integration of blaCTX-M-15 and other resistance genes within a conserved locus, alongside a classical neonatal meningitis E. coli virulence background. Comparative genomics revealed close relatedness to ST1193 strains from countries across multiple continents. This high-risk multi-resistant clone threatens neonates and calls for strengthened surveillance to guide empirical antibiotic therapy.