Characterization of Escherichia coli isolates from hospital inpatients or outpatients with urinary tract infection.
Uropathogenic Escherichia coli (UPEC) is the most common cause of community- and hospital-acquired urinary tract infections (UTIs). Isolates from uncomplicated community-acquired UTIs express a variety of virulence traits that promote the efficient colonization of the urinary tract. In contrast, nosocomial UTIs can be caused by E. coli strains that differ in their virulence traits from the community-acquired UTI isolates. UPEC virulence markers are used to distinguish these facultative extraintestinal pathogens, which belong to the intestinal flora of many healthy individuals, from intestinal pathogenic E. coli (IPEC). IPEC is a diarrheagenic pathogen with a characteristic virulence gene set that is absent in UPEC. Here, we characterized 265 isolates from patients with UTIs during inpatient or outpatient treatment at a hospital regarding their phylogenies and IPEC or UPEC virulence traits. Interestingly, 28 of these isolates (10.6%) carried typical IPEC virulence genes that are characteristic of enteroaggregative E. coli (EAEC), Shiga toxin-producing E. coli (STEC), and atypical enteropathogenic E. coli (aEPEC), although IPEC is not considered a uropathogen. Twenty-three isolates harbored the astA gene coding for the EAEC heat-stable enterotoxin 1 (EAST1), and most of them carried virulence genes that are characteristic of UPEC and/or EAEC. Our results indicate that UPEC isolates from hospital patients differ from archetypal community-acquired isolates from uncomplicated UTIs by their spectrum of virulence traits. They represent a diverse group, including EAEC, as well as other IPEC pathotypes, which in addition contain typical UPEC virulence genes. The combination of typical extraintestinal pathogenic E. coli (ExPEC) and IPEC virulence determinants in some isolates demonstrates the marked genome plasticity of E. coli and calls for a reevaluation of the strict pathotype classification of EAEC.
Institute for Hygiene, University of Münster, Münster, Germany.
Francisco
F
Toval
Christian-Daniel
CD
Köhler
Ulrich
U
Vogel
Florian
F
Wagenlehner
Alexander
A
Mellmann
Angelika
A
Fruth
M Alexander
MA
Schmidt
Helge
H
Karch
Martina
M
Bielaszewska
Ulrich
U
Dobrindt
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D054308:Enteropathogenic Escherichia coli / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology*; D029968:Escherichia coli Proteins / Q000235:genetics; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006761:Hospitals; D006801:Humans; D007223:Infant; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D014552:Urinary Tract Infections / Q000382:microbiology*; D056689:Uropathogenic Escherichia coli / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D037521:Virulence Factors / Q000235:genetics*; D055815:Young Adult
D029968:Escherichia coli Proteins; D037521:Virulence Factors