Bloodstream infection with extended-spectrum beta-lactamase–producing Escherichia coli: The role of virulence genes

Wan Ting Hung, Ming Fang Cheng, Fan Chen Tseng, Yao Shen Chen, Susan Shin-Jung Lee, Tsung Hsien Chang, Hsi Hsun Lin, Chih Hsin Hung, Jiun-Ling Wang

Research output: Contribution to journalArticle

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Abstract

Background: Extraintestinal pathogenic Escherichia coli (ExPEC)strains hold the responsibility for the majority of E. coli infections. Numerous extraintestinal virulence factors (VFs)were possessed by ExPEC which are involved in the pathogenesis of infection. However, the effect of comorbidities or infection syndrome in the association of VFs and mortality remains inconclusive. Method: This study addressed whether specific sequence type (ST)and VFs of extended-spectrum beta-lactamase–producing E. coli (ESBL-EC)are associated with different outcomes in patients with bloodstream infection. 121 adults from southern Taiwan with ESBL-EC bloodstream infections were enrolled during a 6-year period. Demographic data, including infection syndromes, underlying disease and outcomes, were collected. The virulence factors in isolates were analyzed by PCR and multilocus sequence typing analyses were also performed. Result: Positivity for the virulence genes iha, hlyD, sat, iutA, fyuA, malX, ompT, and traT was associated with ST131 positivity (P < 0.05). Some ESBL-EC virulence genes associated with urinary tract infection (UTI)were revealed. Positivity for ST405 and the virulence genes iroN and iss were significantly associated with increased 30-day mortality (death within 30 days)on univariate analysis (P < 0.05). Independent risk factors of 30-day mortality in bacteremic patients with UTI included underlying chronic liver disease and malignancy. ST131 was borderline associated with 30-day mortality. Independent risk factors associated with 30-day mortality among bacteremic patients without UTI included comorbidities and iroN positivity. Conclusion: In bacteremic patients with UTI, and the ST131 clone was borderline associated with mortality. Positivity for the virulence gene iroN may be linked to mortality in bacteremic patients without UTI.

Original languageEnglish
JournalJournal of Microbiology, Immunology and Infection
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Virulence
Urinary Tract Infections
Escherichia coli
Virulence Factors
Mortality
Infection
Genes
Multilocus Sequence Typing
Escherichia coli Infections
Iron
Comorbidity
Taiwan
Liver Diseases
Chronic Disease
Clone Cells
Demography
Polymerase Chain Reaction
Neoplasms

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Hung, Wan Ting ; Cheng, Ming Fang ; Tseng, Fan Chen ; Chen, Yao Shen ; Shin-Jung Lee, Susan ; Chang, Tsung Hsien ; Lin, Hsi Hsun ; Hung, Chih Hsin ; Wang, Jiun-Ling. / Bloodstream infection with extended-spectrum beta-lactamase–producing Escherichia coli : The role of virulence genes. In: Journal of Microbiology, Immunology and Infection. 2019.
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abstract = "Background: Extraintestinal pathogenic Escherichia coli (ExPEC)strains hold the responsibility for the majority of E. coli infections. Numerous extraintestinal virulence factors (VFs)were possessed by ExPEC which are involved in the pathogenesis of infection. However, the effect of comorbidities or infection syndrome in the association of VFs and mortality remains inconclusive. Method: This study addressed whether specific sequence type (ST)and VFs of extended-spectrum beta-lactamase–producing E. coli (ESBL-EC)are associated with different outcomes in patients with bloodstream infection. 121 adults from southern Taiwan with ESBL-EC bloodstream infections were enrolled during a 6-year period. Demographic data, including infection syndromes, underlying disease and outcomes, were collected. The virulence factors in isolates were analyzed by PCR and multilocus sequence typing analyses were also performed. Result: Positivity for the virulence genes iha, hlyD, sat, iutA, fyuA, malX, ompT, and traT was associated with ST131 positivity (P < 0.05). Some ESBL-EC virulence genes associated with urinary tract infection (UTI)were revealed. Positivity for ST405 and the virulence genes iroN and iss were significantly associated with increased 30-day mortality (death within 30 days)on univariate analysis (P < 0.05). Independent risk factors of 30-day mortality in bacteremic patients with UTI included underlying chronic liver disease and malignancy. ST131 was borderline associated with 30-day mortality. Independent risk factors associated with 30-day mortality among bacteremic patients without UTI included comorbidities and iroN positivity. Conclusion: In bacteremic patients with UTI, and the ST131 clone was borderline associated with mortality. Positivity for the virulence gene iroN may be linked to mortality in bacteremic patients without UTI.",
author = "Hung, {Wan Ting} and Cheng, {Ming Fang} and Tseng, {Fan Chen} and Chen, {Yao Shen} and {Shin-Jung Lee}, Susan and Chang, {Tsung Hsien} and Lin, {Hsi Hsun} and Hung, {Chih Hsin} and Jiun-Ling Wang",
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Bloodstream infection with extended-spectrum beta-lactamase–producing Escherichia coli : The role of virulence genes. / Hung, Wan Ting; Cheng, Ming Fang; Tseng, Fan Chen; Chen, Yao Shen; Shin-Jung Lee, Susan; Chang, Tsung Hsien; Lin, Hsi Hsun; Hung, Chih Hsin; Wang, Jiun-Ling.

In: Journal of Microbiology, Immunology and Infection, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Bloodstream infection with extended-spectrum beta-lactamase–producing Escherichia coli

T2 - The role of virulence genes

AU - Hung, Wan Ting

AU - Cheng, Ming Fang

AU - Tseng, Fan Chen

AU - Chen, Yao Shen

AU - Shin-Jung Lee, Susan

AU - Chang, Tsung Hsien

AU - Lin, Hsi Hsun

AU - Hung, Chih Hsin

AU - Wang, Jiun-Ling

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Extraintestinal pathogenic Escherichia coli (ExPEC)strains hold the responsibility for the majority of E. coli infections. Numerous extraintestinal virulence factors (VFs)were possessed by ExPEC which are involved in the pathogenesis of infection. However, the effect of comorbidities or infection syndrome in the association of VFs and mortality remains inconclusive. Method: This study addressed whether specific sequence type (ST)and VFs of extended-spectrum beta-lactamase–producing E. coli (ESBL-EC)are associated with different outcomes in patients with bloodstream infection. 121 adults from southern Taiwan with ESBL-EC bloodstream infections were enrolled during a 6-year period. Demographic data, including infection syndromes, underlying disease and outcomes, were collected. The virulence factors in isolates were analyzed by PCR and multilocus sequence typing analyses were also performed. Result: Positivity for the virulence genes iha, hlyD, sat, iutA, fyuA, malX, ompT, and traT was associated with ST131 positivity (P < 0.05). Some ESBL-EC virulence genes associated with urinary tract infection (UTI)were revealed. Positivity for ST405 and the virulence genes iroN and iss were significantly associated with increased 30-day mortality (death within 30 days)on univariate analysis (P < 0.05). Independent risk factors of 30-day mortality in bacteremic patients with UTI included underlying chronic liver disease and malignancy. ST131 was borderline associated with 30-day mortality. Independent risk factors associated with 30-day mortality among bacteremic patients without UTI included comorbidities and iroN positivity. Conclusion: In bacteremic patients with UTI, and the ST131 clone was borderline associated with mortality. Positivity for the virulence gene iroN may be linked to mortality in bacteremic patients without UTI.

AB - Background: Extraintestinal pathogenic Escherichia coli (ExPEC)strains hold the responsibility for the majority of E. coli infections. Numerous extraintestinal virulence factors (VFs)were possessed by ExPEC which are involved in the pathogenesis of infection. However, the effect of comorbidities or infection syndrome in the association of VFs and mortality remains inconclusive. Method: This study addressed whether specific sequence type (ST)and VFs of extended-spectrum beta-lactamase–producing E. coli (ESBL-EC)are associated with different outcomes in patients with bloodstream infection. 121 adults from southern Taiwan with ESBL-EC bloodstream infections were enrolled during a 6-year period. Demographic data, including infection syndromes, underlying disease and outcomes, were collected. The virulence factors in isolates were analyzed by PCR and multilocus sequence typing analyses were also performed. Result: Positivity for the virulence genes iha, hlyD, sat, iutA, fyuA, malX, ompT, and traT was associated with ST131 positivity (P < 0.05). Some ESBL-EC virulence genes associated with urinary tract infection (UTI)were revealed. Positivity for ST405 and the virulence genes iroN and iss were significantly associated with increased 30-day mortality (death within 30 days)on univariate analysis (P < 0.05). Independent risk factors of 30-day mortality in bacteremic patients with UTI included underlying chronic liver disease and malignancy. ST131 was borderline associated with 30-day mortality. Independent risk factors associated with 30-day mortality among bacteremic patients without UTI included comorbidities and iroN positivity. Conclusion: In bacteremic patients with UTI, and the ST131 clone was borderline associated with mortality. Positivity for the virulence gene iroN may be linked to mortality in bacteremic patients without UTI.

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