title: Role of bacterial virulence factors and host factors in the outcome of Escherichia coli bacteraemia.
abstract: In a study of the role of virulence factors in the outcome of Escherichia coli bacteraemia, blood isolates from 30 hospitalised patients were characterised with regard to O and K antigens, P and type 1 fimbriae, haemolysin production, cytonecrotising factor 1 production, serum resistance, ability to activate neutrophils and resistance to killing. Patients were analysed to identify host factors contributing to morbidity and mortality. In univariate analyses the presence of a K antigen, type 1 fimbriae, absence of haemolysin production, serum resistance and resistance to killing were associated with morbidity and mortality. In multivariate analyses only the absence of haemolysin production was associated with morbidity and mortality, after taking host factors into account. These preliminary findings suggest that host factors override bacterial virulence factors in determining the course of Escherichia coli bacteraemia. The negative association between haemolysin production and clinical deterioration during Escherichia coli bacteraemia might indicate predominance of less virulent strains in patients with other risk factors for morbidity and mortality or inactivation of neutrophil products needed for host defence.
authors.affiliation: Department of Medical Microbiology and Infection Control, University Hospital "Vrije Universiteit", Amsterdam, The Netherlands. tam.hekker@a2vu.nl
authors.forename: T A
authors.initials: TA
authors.lastname: Hekker
authors.forename: A B
authors.initials: AB
authors.lastname: Groeneveld
authors.forename: A M
authors.initials: AM
authors.lastname: Simoons-Smit
authors.forename: P
authors.initials: P
authors.lastname: de Man
authors.forename: H
authors.initials: H
authors.lastname: Connell
authors.forename: D M
authors.initials: DM
authors.lastname: MacLaren
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000209:etiology / Q000382:microbiology* / Q000401:mortality; D001770:Blood Bactericidal Activity; D004926:Escherichia coli / Q000145:classification / Q000302:isolation & purification / Q000472:pathogenicity*; D004927:Escherichia coli Infections / Q000209:etiology / Q000382:microbiology* / Q000401:mortality; D005260:Female; D006460:Hemolysin Proteins / Q000096:biosynthesis; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012044:Regression Analysis; D012307:Risk Factors; D014774:Virulence
chemical_list: D006460:Hemolysin Proteins