Genetic Diversity and Virulence Profiles of Escherichia coli Isolates Causing Spontaneous Bacterial Peritonitis and Bacteremia in Patients with Cirrhosis
Genetic Diversity and Virulence Profiles of Escherichia coli Isolates Causing Spontaneous Bacterial Peritonitis and Bacteremia in Patients with Cirrhosis
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DOI：
10.1128/jcm.00516-10
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发表时间：
2010-08-01
影响因子：
9.4
通讯作者：
Nicolas-Chanoine, Marie-Helene
中科院分区：
文献类型：
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作者：
Bert, Frederic;Johnson, James R.;Nicolas-Chanoine, Marie-Helene
在肝硬化患者中，由肠道转移的大肠杆菌引起的感染是一种常见且严重的并发症。对来自 110 名患有自发性细菌性腹膜炎和/或自发性菌血症的肝硬化患者的 110 株大肠杆菌分离株进行了系统发育群和毒力基因型（34 个肠外毒力因子基因）的特征分析。通过肠细菌重复基因间共有序列 2 型 (ERIC-2) PCR 分型和多位点序列分型研究遗传相关性。系统发育组 A、B1、B2 和 D 分别占种群的 24%、4%、48% 和 24%。总体而言，遇到了 68 种不同的 ERIC-2 配置文件。鉴定出 11 个克隆组，由来自相同序列类型 (ST) 或序列类型复合体的多个分离株（2 至 11）代表。这些克隆组总共占 54 个（49%）分离株。 B2 分离株比非 B2 分离株更频繁地加入这些克隆组之一（67% 对比 32%，P < 0.001）。最常见的序列类型是 ST95 (n = 13) 和 ST73 (n = 8)，其次是 ST14 和 ST10 复合体 (n = 7)。 ST131和ST69各由三个分离株代表。与其他分离株相比，克隆群相关分离株表现出 11 种毒力基因（包括 pap 元件）的流行率更高。然而，没有观察到克隆群体与宿主因素、感染类型或死亡率之间的关联。总之，引起肝硬化患者自发性细菌性腹膜炎和菌血症的大肠杆菌分离株具有遗传多样性。然而，大约一半的分离株属于熟悉的克隆群体，并表现出广泛的毒力特征，这可能与更大的侵入潜力有关。
Among patients with cirrhosis, infections caused by Escherichia coli organisms that translocate from the gut are a frequent and severe complication. One hundred ten E. coli isolates from 110 cirrhotic patients with spontaneous bacterial peritonitis and/or spontaneous bacteremia were characterized for their phylogenetic group and virulence genotype (34 extraintestinal virulence factor genes). Genetic relatedness was investigated by enterobacterial repetitive intergenic consensus sequence type 2 (ERIC-2) PCR typing and multilocus sequence typing. Phylogenetic groups A, B1, B2, and D accounted for 24%, 4%, 48%, and 24% of the population, respectively. Overall, 68 distinct ERIC-2 profiles were encountered. Eleven clonal groups, represented by multiple isolates (2 to 11) from the same sequence type (ST) or sequence type complex, were identified. These clonal groups accounted for 54 (49%) isolates overall. Membership in one of these clonal groups was more frequent among B2 isolates than non-B2 isolates (67% versus 32%, P < 0.001). The most frequent sequence types were ST95 (n = 13) and ST73 (n = 8), followed by the ST14 and ST10 complexes (n = 7). ST131 and ST69 were represented by three isolates each. Clonal group-associated isolates exhibited a greater prevalence of 11 virulence genes, including pap elements, than the other isolates. However, no association between clonal groups and host factors, type of infection, or mortality was observed. In conclusion, E. coli isolates causing spontaneous bacterial peritonitis and bacteremia in cirrhotic patients are genetically diverse. However, approximately half of the isolates belong to familiar clonal groups and exhibit extensive virulence profiles that may be associated with greater invasive potential.