Clinical features and microbiological characteristics of hospital- and community-onset Escherichia coli bloodstream infection

J Med Microbiol. 2019 Feb;68(2):178-187. doi: 10.1099/jmm.0.000904. Epub 2019 Jan 9.

Abstract

Purpose: Escherichia coli is a leading cause of bloodstream infection (BSI) in hospitals and communities.

Methodology: We conducted a retrospective study in 2015 to evaluate the clinical features and microbiological characteristics of E. coli BSI acquired in the hospital and community.

Results: A total of 100 patients with E. coli BSI were enrolled, among whom 60 % had hospital-onset (HO) BSI while 40 % had community-onset (CO) BSI. Patients with HO BSI had higher percentages of haematological disorders, immunosuppression conditions, underwent surgery within 2 weeks and had a higher 30-day mortality. The prevalences of multidrug-resistant and extended-spectrum β-lactamase-producing strains were 81 and 60 %, respectively. Resistance percentages to ampicillin, ampicillin-sulbactam, cefazolin, ceftriaxone, ciprofloxacin and levofloxacin were greater than 50 %. Of the 43 different sequence types (STs) identified, ST131 (15.3 %) was the most common. The serum agglutination rate was 52 % in which 13 O and 11 H serogroups were observed. Among the 36 detected virulence factor (VF) genes, IutA (66 %) and traT (61 %) were the most predominant. papA, papC and papEF were different between the CO and HO BSI groups. VF scores were high (mean >7) in the frequently detected ST95, ST1193 and ST131.

Conclusion: This study revealed that the clinical features of HO and CO E. coli BSI were different. STs and serotypes showed a great diversity in this region while VF genes of the isolates varied between clones.

Keywords: Escherichia coli; ST 131; bloodstream infection; serotype; virulence factor genes.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Agglutination Tests
  • Bacteremia / microbiology*
  • Community-Acquired Infections / microbiology*
  • Cross Infection / microbiology*
  • Escherichia coli / classification*
  • Escherichia coli / genetics
  • Escherichia coli / immunology
  • Escherichia coli / pathogenicity
  • Escherichia coli Infections / microbiology*
  • Humans
  • Male
  • Middle Aged
  • Multilocus Sequence Typing
  • Phylogeny
  • Retrospective Studies
  • Serogroup
  • Virulence Factors / genetics

Substances

  • Virulence Factors