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

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

Chen X1,2, Zou Q1, Zhang W1,2, Wang R1, Yu F1, Chen Y1,2.

Author information

1
1​Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Department of Clinical Laboratory, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang, PR China.
2
2​State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang, PR China.

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

PMID:
30624177
DOI:
10.1099/jmm.0.000904
[Indexed for MEDLINE]

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