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Infection and Immunity, July 2000, p. 3983-3989, Vol. 68, No. 7
0019-9567/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Prevalence of Virulence Genes and Clonality in Escherichia coli Strains That Cause Bacteremia in Cancer Patients

Farida Hilali,1,2 Raymond Ruimy,1 Patrick Saulnier,2 Christian Barnabé,3 Chantal Lebouguénec,4 Michel Tibayrenc,3 and Antoine Andremont1,*

EMI INSERM 9933, AP-HP Hôpital Bichat Claude-Bernard,1 and Unité de Pathogénie Bactérienne des Muqueuses, Institut Pasteur,4 Paris, Laboratoire de Microbiologie Médicale, Institut Gustave Roussy, Villejuif,2 and Centre d'Etudes sur le Polymorphisme des Microorganismes (CEPM), UMR CNRS/IRD 9926, IRD, Montpellier,3 France

Received 20 April 1999/Returned for modification 30 June 1999/Accepted 31 March 2000

Phenotypic analysis of Escherichia coli strains causing bacteremia in cancer patients suggests that they possess specific virulence properties. To investigate this hypothesis, we compared the frequency of the virulence-related genes cnf1, cnf2, papC, hlyC, and iut in 155 E. coli strains isolated from hospitalized cancer patients with epidemiologically unrelated cases of bacteremia to their frequency in 70 E. coli strains isolated from the feces of healthy unrelated volunteers. Of the blood isolates, 24, 37, and 26% were positive for cnf1, papC, and hlyC, respectively, versus only 6, 17, and 6% of the fecal isolates (P < 0.05 in all instances). By contrast, 47% of both isolates carried the iut gene. The patients' clinical characteristics did not significantly influence these frequencies. The presence on various pathogenicity islands (PAIs) of a combination of the cnf1, papC, and hlyC genes on the chromosome was strongly suggested by Southern blotting of pulsed-field gel electrophoresis (PFGE) patterns with specific DNA probes. The phylogenetic relatedness among 60 strains carrying three, two, one, or no virulence genes and 6 ECOR strains included as references was determined by neighbor joining, the unweighted pair-group method with arithmetic mean, and Wagner analysis of the randomly amplified polymorphic DNA (RAPD) patterns generated by 11 primers. Identification of a major cluster including 96.4% of the strains carrying the cnf1, papC, and hlyC genes and ECOR subgroup B2 strains suggested that the virulent E. coli strains causing bacteremia in cancer patients are closely related to ECOR B2 strains. The presence in the E. coli population surveyed of a strong linkage disequilibrium, and especially of a highly significant correlation between PFGE and RAPD genetic distances, confirms that clonal propagation has a major impact on the E. coli population structure. Nevertheless, low bootstrap values in the phylogenetic tree suggested that frequent genetic exchange inhibits the individualization of discrete genetic lineages, which are stable on an evolutionary scale.

* Corresponding author. Mailing address: Laboratoire de Bactériologie, Groupe Hospitalier Bichat-Claude Bernard, 47, rue Henri Huchard, 75877 Paris Cedex 18, France. Phone: 33 (0)1 40 25 85 00. Fax: 33 (0)1 40 25 85 81. E-mail: antoine.andremont{at}bch.ap-hop-paris.fr.

Infection and Immunity, July 2000, p. 3983-3989, Vol. 68, No. 7
0019-9567/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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