title: Escherichia coli bacteraemia in pregnant women is life-threatening for foetuses.
abstract: In order to improve knowledge on Escherichia coli bacteraemia during pregnancy, we studied clinical data and performed molecular characterization of strains for 29 E. coli bacteraemia occurring in pregnant women. Bacteraemia mostly occurred in the third trimester of pregnancy (45%) and was community-acquired (79%). Portals of entry were urinary (55%) and genital (45%). E. coli strains belonged mainly to phylogroups B2 (72%) and D (17%). Four clonal lineages (i.e. sequence type complex (STc) 73, STc95, STc12 and STc69) represented 65% of the strains. The strains exhibited a high number of virulence factor coding genes (10 (3-16)). Six foetuses died (27%), five of them due to bacteraemia of genital origin (83%). Foetal deaths occurred despite adequate antibiotic regimens. Strains associated with foetal mortality had fewer virulence factors (8 (6-10)) than strains involved in no foetal mortality (11 (4-12)) (p 0.02). When comparing E. coli strains involved in bacteraemia with a urinary portal of entry in non-immunocompromised pregnant vs. non-immunocompromised non-pregnant women from the COLIBAFI study, there was no significant difference of phylogroups and virulence factor coding genes. These results show that E. coli bacteraemia in pregnant women involve few highly virulent clones but that severity, represented by foetal death, is mainly related to bacteraemia of genital origin.
authors: Service des Maladies Infectieuses et Tropicales, AP-HP, Hôpital Saint-Antoine, Paris, France; Université Paris VI - Pierre et Marie Curie, Paris, France.
authors: L
authors: L
authors: Surgers
authors: A
authors: A
authors: Bleibtreu
authors: C
authors: C
authors: Burdet
authors: O
authors: O
authors: Clermont
authors: C
authors: C
authors: Laouénan
authors: A
authors: A
authors: Lefort
authors: F
authors: F
authors: Mentré
authors: B
authors: B
authors: Carbonne
authors: E
authors: E
authors: Bingen
authors: J-L
authors: JL
authors: Meynard
authors: E
authors: E
authors: Denamur
mesh_terms: D000293:Adolescent; D000328:Adult; D016470:Bacteremia / Q000150:complications*; D017714:Community-Acquired Infections / Q000150:complications / Q000382:microbiology; D004926:Escherichia coli / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000150:complications* / Q000382:microbiology*; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology*; D012189:Retrospective Studies; D016019:Survival Analysis; D037521:Virulence Factors / Q000235:genetics; D055815:Young Adult
chemical_list: D037521:Virulence Factors
keywords: Bacteraemia; Escherichia coli; chorioamnionitis; foetal mortality; phylogenetic group; pregnancy; virulence