O2:K7:H6 肠外致病性大肠杆菌（ExPEC）与原发性心脏瓣膜心内膜炎的因果关系：一例报告。
The causal relationship between O2:K7:H6 extra-intestinal pathogenic Escherichia coli (ExPEC) and native valve endocarditis: a case report.
机构信息
Laboratoire Synlab, 4020, Liège, Belgium.
Department of Microbiology, Cliniques universitaires St-Luc, Université catholique de Louvain, Brussels, Belgium.
出版信息
BMC Infect Dis. 2021 Apr 20;21(1):370. doi: 10.1186/s12879-021-06066-y.
BACKGROUND
Native valves infective endocarditis due to Escherichia coli is still a rare disease and a particular virulence of some E.coli isolate may be suspected.
CASE PRESENTATION
A 79-year-old woman presented during the post-operative period of an orthopedic surgery a urinary tract infection following obstructive ureteral lithiasis. E. coli was isolated from a pure culture of urine and blood sampled simultaneously. After evidence of sustained E.coli septicemia, further investigations revealed acute cholecystitis with the same micro-organism in biliary drainage and a native valve mitral endocarditis. E.coli was identified as O2:K7:H6, phylogenetic group B2, ST141, and presented several putative and proven virulence genes. The present isolate can be classified as both extra-intestinal pathogenic E.coli (ExPEC) and uropathogenic E. coli (UPEC).
CONCLUSIONS
The relationship between the virulent factors present in ExPEC strains and some serotypes of E. coli that could facilitate the adherence to cardiac valves warrants further investigation.
背景
由大肠杆菌引起的心脏原生瓣膜感染性心内膜炎仍然是一种罕见疾病，可能怀疑某些大肠杆菌分离株具有特殊的毒力。
病例介绍
一名 79 岁女性在骨科手术后出现尿路梗阻性结石引起的尿路感染。尿液和血液的纯培养均分离出大肠杆菌。在持续的大肠杆菌败血症证据出现后，进一步的调查显示合并有相同微生物的急性胆囊炎和原生瓣膜二尖瓣心内膜炎。大肠杆菌被鉴定为 O2:K7:H6、进化群 B2、ST141，且具有多种可能的和已证实的毒力基因。该分离株可归类为肠外致病性大肠杆菌（ExPEC）和尿路致病性大肠杆菌（UPEC）。
结论
在 ExPEC 菌株中存在的毒力因子与某些可促进黏附在心脏瓣膜上的大肠杆菌血清型之间的关系值得进一步研究。
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