Center for Research and Development Gävleborg, Uppsala University, Gävle, Sweden.
Department of Clinical Microbiology, Gävle Hospital, Gävle, Sweden.
J Infect Dis. 2024 Nov 15;230(5):e1136-e1145. doi: 10.1093/infdis/jiae309.
This study sought to investigate associations between virulence factors and phylogeny in all neonatal Escherichia coli bloodstream infections from patients admitted to the neonatal intensive care unit at Uppsala University Hospital between 2005 and 2020.
A total of 37 E. coli isolates from 32 neonates were whole-genome sequenced and analyzed for virulence factors related to extraintestinal E. coli; patient-related data were collected retrospectively from the medical records.
E. coli isolates that belong to phylogroup B2 were associated with mortality (odds ratio [OR], 26; P < .001), extreme prematurity with delivery before gestational week 28 (OR, 9; P < .05), and shock (OR, 9; P < .05) compared with isolates of non-B2 group. Female neonates were more often infected with isolates of phylogroup B2 E. coli compared with male neonates (OR, 7; P = .05). The identification of the genotoxin determinant clb coding for colibactin exhibited strong associations with mortality (OR, 67; P < .005), gestational age (OR, 18; P < .005), and shock (OR, 26; P < .005).
The study highlighted the correlation between neonatal E. coli bacteremia caused by phylogroup B2 and the role of colibactin. Results emphasize difference between male and female neonates in E. coli populations in bloodstream infections.
本研究旨在调查毒力因子与 2005 年至 2020 年期间在乌普萨拉大学医院新生儿重症监护病房住院的新生儿血流感染的所有大肠杆菌的系统发育之间的关联。
对 32 名新生儿的 37 株大肠杆菌分离株进行全基因组测序，并分析与肠道外大肠杆菌相关的毒力因子；从病历中回顾性收集患者相关数据。
与非 B2 组分离株相比，属于 B2 群的大肠杆菌分离株与死亡率（比值比 [OR]，26；P<0.001）、极早产（妊娠 28 周前分娩，OR，9；P<0.05）和休克（OR，9；P<0.05）相关。与男性新生儿相比，女性新生儿更常被 B2 群大肠杆菌分离株感染（OR，7；P=0.05）。鉴定出的 colibactin 产生基因 clb 与死亡率（OR，67；P<0.005）、胎龄（OR，18；P<0.005）和休克（OR，26；P<0.005）之间存在强烈关联。
该研究强调了 B2 群大肠杆菌引起的新生儿血流感染与 colibactin 的相关性。结果强调了男性和女性新生儿在血流感染大肠杆菌群体中的差异。
