title: Genomic analysis and clinical importance of Escherichia coli isolate from patients with sepsis.
abstract: BACKGROUND
  Escherichia coli is a major cause of bloodstream infections and death due to sepsis. Bacteremic isolates harbor a significantly greater repertoire of virulence factors (VFs) in contrast with commensal E. coli isolates.
  
  
  OBJECTIVE
  The aim was to determine the relationships between E. coli VFs, phylogenetic groups, and their clinical importance.
  
  
  METHODS
  This descriptive study was carried out in a multi-specialty tertiary care hospital.
  
  
  METHODS
  Escherichia coli isolates from consecutive episodes of bacteremia in 100 patients were screened for their VFs, phylogenetic group, and their effect on patient's clinical outcome. Virulence genes of all isolates were determined by multiplex polymerase chain reaction (PCR). Phylogenetic analysis was performed by triplex PCR methods. Estimation of risk of death was calculated using APACHE score II calculator.
  
  
  RESULTS
  Of the 100 patients, the most common predisposing factors were diabetes (42%), followed by carcinoma (23%). On analysis of the VF genes of the isolates, a majority of strains (88%) were possessing the fimH gene followed by iutA (76%), papC (44%), cnf1 (16%), hlyA (16%) and neuC (5%) respectively. Phylogenetic analysis revealed that 25 (25%) isolates belonged to phylogroup A, 8(8%) strains to group B1, 30 (30%) were from group B2 and 37 (37%) were from group D. The incidence of iutA gene was significant in higher APACHE II score group.
  
  
  CONCLUSIONS
  Our findings indicate that virulent as well as commensal strains are capable of causing sepsis. Host related predisposing factors, adherence factors, and iron uptake are essential for the survival of the sepsis inducing strains.
authors: Department of Microbiology, Government Medical College, Ambedkar Nagar, Uttar Pradesh, India.
authors: Arindam
authors: A
authors: Chakraborty
authors: Prabha
authors: P
authors: Adhikari
authors: Shalini
authors: S
authors: Shenoy
authors: Vishwas
authors: V
authors: Saralaya
mesh_terms: D018806:APACHE; D004926:Escherichia coli / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology*; D016680:Genome, Bacterial; D060005:Genotyping Techniques; D006801:Humans; D010802:Phylogeny; D018805:Sepsis / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology*; D016019:Survival Analysis; D037521:Virulence Factors / Q000235:genetics*
chemical_list: D037521:Virulence Factors