Genomes of Escherichia coli bacteraemia isolates originating from urinary tract foci contain more virulence-associated genes than those from non-urinary foci and neutropaenic hosts.
Genomes of Escherichia coli bacteraemia isolates originating from urinary tract foci contain more virulence-associated genes than those from non-urinary foci and neutropaenic hosts.
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DOI：
10.1016/j.jinf.2018.10.011
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
Read RC
中科院分区：
文献类型：
--
作者：
Dale AP;Pandey AK;Hesp RJ;Belogiannis K;Laver JR;Shone CC;Read RC
大肠杆菌是导致菌血症的主要原因。在出现多重耐药菌株的时代，了解与特定感染综合征/患者群体相关的菌株多样性将有助于制定有效的预防策略。我们假设从中性粒细胞减少的患者中分离出来的菌血症中毒力因子（VF）基因的数量要低于从免疫正常的患者中分离出来的菌血症。前瞻性地招募了免疫正常和中性粒细胞减少的大肠杆菌菌血症成人，并确定了菌血症的来源。全基因组测序后，在计算机上建立VF基因谱。患者个体分离株为单克隆。尿路感染灶（utf）免疫功能正常患者（10,2 - 22,p = 0.0058）和中性粒细胞减少未知感染灶（NPUFI）患者（8,3 - 13,p < 0.0001）的分离株中含有更多的VF基因（VF基因中位数16，范围8 - 24）。VF基因数量（OR为1.21,95% ci为1.01-1.46,p = 0.039）和尿路导管/复发性尿路感染（OR为12.82,95% ci为1.24-132.65,p = 0.032）是免疫功能正常患者utf继发菌血症与非utf继发菌血症的独立预测因子。在免疫功能正常的患者中，papA、papC、papE/F、papG、agn43、tia、iut、fyuA、kpsM和sat在utf与非utf源性分离株中明显更普遍，而papC、papE/F、papG、agn43、tia、fyuA、hlyA、usp和clb在utf与npufi相关分离株中明显更普遍。源自utf的菌血症相关大肠杆菌菌株与非utf和NPUFI相关菌株具有不同的VF基因谱。这种多样性必须在未来疫苗的设计中加以解决，以确保充分覆盖导致特定地点疾病的毒株。
Escherichia coli is the leading cause of bacteraemia. In an era of emerging multi-drug-resistant strains, development of effective preventative strategies will be informed by knowledge of strain diversity associated with specific infective syndromes/patient groups. We hypothesised that the number of virulence factor (VF) genes amongst bacteraemia isolates from neutropaenic patients would be lower than isolates from immunocompetent patients. Immunocompetent and neutropaenic adults with E. coli bacteraemia were recruited prospectively and the source of bacteraemia determined. VF gene profiles were established in silico following whole genome sequencing. Isolates from individual patients were monoclonal. Strains from immunocompetent patients with urinary tract infective foci (UTIF) harboured more VF genes (median number of VF genes 16, range 8–24) than isolates from both immunocompetent patients with non-UTIF (10, 2–22, p = 0.0058) and neutropaenic patients with unknown focus of infection (NPUFI) (8, 3–13, p < 0.0001). Number of VF genes (OR 1.21, 95% CIs 1.01–1.46, p = 0.039) and urinary catheter/recurrent urinary tract infection (OR 12.82, 95% CIs 1.24–132.65, p = 0.032) were independent predictors of bacteraemia secondary to UTIF vs. non-UTIF in immunocompetent patients. papA, papC, papE/F, papG, agn43, tia, iut, fyuA, kpsM and sat were significantly more prevalent amongst UTIF- vs non-UTIF-originating isolates amongst immunocompetent patients, while papC, papE/F, papG, agn43, tia, fyuA, hlyA, usp and clb were significantly more prevalent amongst UTIF- vs NPUFI-associated isolates. Bacteraemia-associated E. coli strains originating from UTIF have distinct VF gene profiles from strains associated with non-UTIF- and NPUFI. This diversity must be addressed in the design of future vaccines to ensure adequate coverage of strains responsible for site-specific disease.
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DOI：
10.1038/nrmicro1952
发表时间：
2008-08
期刊：
Nature reviews. Microbiology
影响因子：
--
作者：
通讯作者：
--
影响因子：
9.4
作者：
MADICO, G;AKOPYANTS, NS;BERG, DE
通讯作者：
BERG, DE
影响因子：
3.8
作者：
Er, Doganhan Kadir;Dundar, Devrim;Osmani, Agim
通讯作者：
Osmani, Agim
影响因子：
14.2
作者：
Magiorakos, A. -P.;Srinivasan, A.;Monnet, D. L.
通讯作者：
Monnet, D. L.
影响因子：
4.1
作者：
Micenkova, Lenka;Benova, Alzbeta;Smajs, David
通讯作者：
Smajs, David