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Infection and Immunity, September 2001, p. 5363-5374, Vol. 69, No. 9
0019-9567/01/$04.00+0   DOI: 10.1128/IAI.69.9.5363-5374.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Ongoing Horizontal and Vertical Transmission of Virulence Genes and papA Alleles among Escherichia coli Blood Isolates from Patients with Diverse-Source Bacteremia

James R. Johnson,1,2,* Timothy T. O'Bryan,1,2 Michael Kuskowski,3,4 and Joel N. Maslow5,6

Medical Service1 and Geriatric Research, Education, and Clinical Center,3 Minneapolis VA Medical Center, and Departments of Medicine2 and Psychiatry,4 University of Minnesota, Minneapolis, Minnesota, and Medical Service, Philadelphia VA Medical Center,5 and Department of Medicine, University of Pennsylvania,6 Philadelphia, Pennsylvania

Received 9 February 2001/Returned for modification 4 April 2001/Accepted 31 May 2001

The phylogenetic distributions of multiple putative virulence factors (VFs) and papA (P fimbrial structural subunit) alleles among 182 Escherichia coli blood isolates from patients with diverse-source bacteremia were defined. Phylogenetic correspondence among these strains, the E. coli Reference (ECOR) collection, and other collections of extraintestinal pathogenic E. coli (ExPEC) was assessed. Although among the 182 bacteremia isolates phylogenetic group B2 predominated, exhibited the greatest concentration of individual VFs, and contained the largest number of familiar virulent clones, other phylogenetic groups exhibited greater concentrations of certain VFs than did group B2 and included several additional virulent clones. Certain of the newly detected VF genes, e.g., fyuA (yersiniabactin; 76%) and focG (F1C fimbriae; 25%), were as prevalent or more prevalent than their more familiar traditional counterparts, e.g., iut (aerobactin; 57%) and sfaS (S fimbriae; 14%), thus possibly offering additional useful targets for preventive interventions. Considerable diversity of VF profiles was observed at every level within the phylogenetic tree, including even within individual lineages. This suggested that many different pathways can lead to extraintestinal virulence in E. coli and that the evolution of ExPEC, which involves extensive horizontal transmission of VFs and continuous remodeling of pathogenicity-associated islands, is a highly active, ongoing process.

* Corresponding author. Mailing address: Infectious Diseases (111F), VA Medical Center, One Veterans Dr., Minneapolis, MN 55417. Phone: (612) 725-2000, ext. 4185. Fax: (612) 727-5995. E-mail: johns007{at}tc.umn.edu.

Infection and Immunity, September 2001, p. 5363-5374, Vol. 69, No. 9
0019-9567/01/$04.00+0   DOI: 10.1128/IAI.69.9.5363-5374.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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