Extra-corporeal membrane oxygenation-associated infections: implication of extra-intestinal pathogenic Escherichia coli clones

J Med Microbiol. 2017 Aug;66(8):1189-1195. doi: 10.1099/jmm.0.000554. Epub 2017 Aug 4.

Abstract

Extra-corporeal membrane oxygenation (ECMO) is a promising life-saving technique for critically ill patients. Bacterial infection is a frequent complication, and Escherichia coli the predominant causative pathogen, but little is known about the characteristics of E. coli strains in these infections. We therefore conducted a retrospective study of 33 E. coli strains responsible for 33 ECMO-related infections, in 30 subjects. Antimicrobial susceptibility, phylotyping, O-typing, clonal relatedness determination and the screening for four virulence factor genes were conducted. Polymicrobial infections were evidenced in 61.6 % of episodes, irrespective of E. coli characteristics. Extra-intestinal pathogenic strains represented the large majority (69.7 %) of all E. coli isolates. Their advantageous genetic background may explain their predominance in this context. The potential for targeted digestive decontamination should be investigated in these patients for whom infectious complications are a heavy burden.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / pharmacology
  • Equipment Contamination
  • Equipment and Supplies, Hospital / microbiology*
  • Escherichia coli / classification
  • Escherichia coli / drug effects
  • Escherichia coli / genetics
  • Escherichia coli / isolation & purification*
  • Escherichia coli Infections / etiology
  • Escherichia coli Infections / microbiology*
  • Escherichia coli Proteins / genetics
  • Escherichia coli Proteins / metabolism
  • Extracorporeal Membrane Oxygenation / adverse effects*
  • Female
  • Genotype
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Phylogeny
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents
  • Escherichia coli Proteins